Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri.
Department of Orthopaedic Spine Surgery, University of Colorado at Colorado Springs, Colorado Springs, Colorado.
JBJS Case Connect. 2020 Apr-Jun;10(2):e0627. doi: 10.2106/JBJS.CC.19.00627.
We present the case of a 69-year-old man arriving to our clinic after a previous outside hospital recommendation of L1-S1 fusion due to degenerative scoliosis. A thoracic spine synovial cyst was identified through magnetic resonance imaging. The patient had rapid progression of his neurologic deficit due to cyst enlargement. We elected to perform cyst decompression and instrumented fusion of the involved thoracic segment. The patient rapidly regained full neurologic function. After the one-year follow-up, he remained asymptomatic with no progression of thoracolumbar degeneration.
Thoracic spine synovial facet cysts are uncommonly encountered. Decompression alone or decompression and fusion are both viable treatment options depending on the surgeon's assessment of spine stability after decompression. This diagnosis should be considered in patients presenting with unilateral lower extremity upper motor neuron findings.
患者为 69 岁男性，因退行性脊柱侧凸在外院接受 L1-S1 融合术的建议后到我院就诊。磁共振成像显示患者存在胸椎滑膜囊肿。由于囊肿增大，患者的神经功能缺损迅速进展。我们选择进行囊肿减压和受累胸椎节段的器械融合。患者的神经功能迅速完全恢复。随访 1 年后，患者无胸腰椎退变进展，也无症状。
胸椎滑膜关节突囊肿少见。单纯减压或减压加融合均为可行的治疗选择，具体取决于减压后脊柱稳定性的外科医生评估。对于单侧下肢上运动神经元表现的患者，应考虑此诊断。
