Senn M, Goebel N, Gerber H
Schweiz Rundsch Med Prax. 1990 Mar 6;79(10):284-6.
Synovial cysts of various joints and tendon sheaths (knee, elbow, hip, proximal interphalangeal joints are well known. Cysts arising from the zygapophyseal joints however are rare, but not unknown. 3 patients with lumbosciatic pain, due to nerve root compression by a synovial cyst of the zygapophyseal joints are described. The age ranged from 54 to 77 years. There are 2 men and 1 woman. The symptoms and signs involved the fourth (1 patient) and fifth (1 patient) lumbal nerve root and the first sacral nerve root (1 patient). X-rays showed degenerative changes of the facet joints in 2 cases and spondylolisthesis in 1 case. Myelography revealed compression of the fifth lumbar and the first sacral nerve root, but did not allow to make the exact diagnoses. CT scans however made the diagnoses possible in all 3 cases. Treatment was surgical excision of the cyst in 2 cases, 1 patient showed pain relief after steroid-infiltration in the affected facet joint.
各种关节和腱鞘(膝关节、肘关节、髋关节、近端指间关节)的滑膜囊肿是众所周知的。然而,由关节突关节产生的囊肿很少见,但并非不为人知。本文描述了3例因关节突关节滑膜囊肿压迫神经根而导致腰腿痛的患者。年龄在54岁至77岁之间。有2名男性和1名女性。症状和体征累及第四(1例患者)和第五(1例患者)腰神经根以及第一骶神经根(1例患者)。X线显示2例患者有小关节退变改变,1例患者有椎体滑脱。脊髓造影显示第五腰椎和第一骶神经根受压,但无法做出准确诊断。然而,CT扫描在所有3例患者中都做出了诊断。2例患者接受了囊肿手术切除治疗,1例患者在患侧小关节内注射类固醇后疼痛缓解。