The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
World Neurosurg. 2019 Jul;127:85-91. doi: 10.1016/j.wneu.2019.02.237. Epub 2019 Apr 4.
Perineural cysts are a benign spine pathology but, when they become symptomatic and require surgical treatment, represent a significant challenge to the spine surgeon. Here we describe our experience with a novel endoscopic approach to the biopsy, drainage, resection of the cyst wall, and direct cyst fenestration to the subarachnoid space.
A transforaminal endoscopic approach to a large lumbar 2-3 perineural cyst is presented here in a 25-year-old patient. A step-by-step technique for the biopsy, drainage, and resection of the cyst wall is presented.
The patient underwent cyst resection and fenestration into the subarachnoid space without complication, with immediate relief of his preoperative symptoms and after 1 year remains symptom-free.
Surgical treatment of perineural cysts in the spine represent a significant challenge to the surgeon, principally due to the risk of spinal fluid leak in the postoperative period. Transforaminal endoscopic surgical access to this disease pathology is a novel minimally invasive surgical approach presented here that allows diagnosis and treatment of a perineural cyst and can be performed in an awake patient.
神经周围囊肿是一种良性脊柱病变，但当它们出现症状并需要手术治疗时，会给脊柱外科医生带来重大挑战。在这里，我们描述了一种新的内镜方法，用于对囊肿进行活检、引流、切除囊壁，并直接将囊肿开窗至蛛网膜下腔。
我们在此介绍了一种经椎间孔内镜入路治疗 25 岁患者的大型腰椎 2-3 神经周围囊肿的方法。介绍了一种用于活检、引流和切除囊壁的分步技术。
患者接受了囊肿切除术和蛛网膜下腔开窗术，无并发症，术前症状立即缓解，1 年后仍无症状。
脊柱神经周围囊肿的手术治疗对外科医生来说是一个重大挑战，主要是因为术后有脑脊液漏的风险。经椎间孔内镜手术入路是一种新的微创外科方法，可用于诊断和治疗神经周围囊肿，并且可以在清醒患者中进行。
