Department of Orthopedic Surgery, Kagoshima Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
J Neurointerv Surg. 2012 Jul;4(4):e17. doi: 10.1136/neurintsurg-2011-010017. Epub 2011 Jul 29.
A rare case is presented of a synovial cyst located at the level of C3-C4 that caused cervical myelopathy and that was preoperatively diagnosed by facet arthrography. A woman in her late seventies experienced muscle weakness and numbness in her right upper extremity and gait disturbance. MRI revealed an extradural lesion located dorsolaterally on the right side of the spinal cord at the level of C3-C4. CT facet arthrography revealed continuity of the extradural lesion with the right C3-C4 facet joint and infiltration of contrast medium into the lesion. Postoperatively, histological examination of the cyst showed fibrous tissue with calcium deposits and the presence of synovial lining. Preoperatively, cervical synovial cysts are often difficult to distinguish from other extradural lesions. In this case, facet arthrography allowed the preoperative determination of communication between the extradural lesion and the facet joint, leading to the diagnosis of a synovial cyst.
现报告 1 例罕见的发生于 C3-C4 水平的滑膜囊肿病例，该囊肿引起颈髓病，并通过小关节造影术术前诊断。一位 70 多岁的女性出现右侧上肢肌无力和麻木，以及步态障碍。MRI 显示 C3-C4 水平脊髓右侧背外侧有硬膜外病变。CT 小关节造影显示硬膜外病变与右侧 C3-C4 小关节连续性，造影剂渗透到病变中。术后，囊肿的组织学检查显示纤维组织伴钙沉积和滑膜衬里。术前，颈椎滑膜囊肿常难以与其他硬膜外病变相鉴别。在本例中，小关节造影术可术前确定硬膜外病变与小关节之间的连通，从而诊断为滑膜囊肿。
