Sobol Garret L, Lipschultz Todd M
Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA.
Am J Orthop (Belle Mead NJ). 2015 Apr;44(4):E123-6.
Intraneural ganglion cysts of peripheral nerves occurring within the epineural sheath are rare, and their mechanism of formation and treatment options are debated. We present a case of a 41-year-old man who presented with a complaint of lateral-sided left knee pain with numbness on the lateral side of the foot who was diagnosed with an intraneural ganglion of the common peroneal nerve (CPN). He was treated initially with common peroneal epineural decompression only to have symptoms recur 6 weeks postoperatively. The patient was subsequently treated utilizing the suggestions of the "unified articular theory," which proposes a small recurrent articular branch of the CPN as the source of cyst fluid. This branch was surgically detached, leading to complete alleviation of his symptoms. When the patient was reevaluated 2 years postoperatively, his preoperative symptoms had resolved, and a follow-up magnetic resonance image showed resolution of the enlargement of the CPN.
发生于神经外膜鞘内的周围神经神经内腱鞘囊肿罕见,其形成机制和治疗方案存在争议。我们报告一例41岁男性患者,主诉左侧膝关节外侧疼痛伴足外侧麻木,诊断为腓总神经神经内腱鞘囊肿。患者最初接受了腓总神经外膜减压治疗,但术后6周症状复发。随后,根据“统一关节理论”的建议对患者进行治疗,该理论提出腓总神经的一个小的反复分支是囊肿液的来源。该分支被手术分离,患者症状完全缓解。术后2年对患者进行复查时,其术前症状已消失,随访磁共振成像显示腓总神经增粗已消退。