Seo Dong-Ho, Park Hye-Ran, Oh Jae-Sang, Doh Jae-Won
Department of Neurosurgery, Soonchunhyang University College of Medicine, Cheonan, Korea.
Korean J Spine. 2014 Mar;11(1):18-21. doi: 10.14245/kjs.2014.11.1.18. Epub 2014 Mar 31.
Ligamentum flavum cysts have rarely been reported and known to be the uncommon cause of spinal compression and radiculopathy. A 63-year-old man presented right sciatica lasting for 1 month. Lumbar computerized tomography and magnetic resonance imaging demonstrated an extradural cystic mass adjacent to the L5-S1 facet joints. Partial hemilaminectomy and flavectomy at the L5-S1 space were performed, and then the cystic mass was excised. Histopathology confirmed a connective tissue cyst, which is consistent with the ligamentum flavum. Microscopic examination of the cyst wall revealed that it is closely packed collagen fibril. The symptom of patient was improved after surgery. Because of rarity of ligamentum flavum cysts and nonspecific clinical and radiologic findings, the preoperative diagnosis is not easy. The histologic features of ligamentum flavum cysts are distinct from other cystic lesion of lumbar spine. This study presents a case and literature review of ligamentum flavum cyst. We summarize the pathophysiology, occurrence, differential diagnosis of rare ligamentum flavum cyst, especially on lumbar spine.
黄韧带囊肿鲜有报道，是导致脊髓受压和神经根病的罕见原因。一名63岁男性出现右侧坐骨神经痛，持续1个月。腰椎计算机断层扫描和磁共振成像显示L5 - S1小关节旁有硬膜外囊性肿块。在L5 - S1间隙进行了部分半椎板切除术和黄韧带切除术，然后切除了囊性肿块。组织病理学证实为结缔组织囊肿，与黄韧带相符。对囊肿壁的显微镜检查显示其为紧密排列的胶原纤维。患者术后症状得到改善。由于黄韧带囊肿罕见且临床和影像学表现不具特异性，术前诊断并不容易。黄韧带囊肿的组织学特征与腰椎的其他囊性病变不同。本研究报告了一例黄韧带囊肿病例并进行文献综述。我们总结了罕见的黄韧带囊肿，尤其是腰椎黄韧带囊肿的病理生理学、发病情况及鉴别诊断。
