Ruggeri Luca, Brunasso Lara, Urrico Giovanni, Alessandrello Raffaele, Cinquemani Giovanni, Lipani Rita, Mandelli Jaime, Nobile Francesco, Iacopino Domenico Gerardo, Maugeri Rosario
Department of Neurosurgery, S. Elia Hospital, Caltanissetta, Italy.
Department of Neurosurgery, Neurosurgical Clinic, AOUP "Paolo Giaccone," Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, University of Palermo, Palermo, Italy.
Surg Neurol Int. 2021 Jul 27;12:369. doi: 10.25259/SNI_574_2021. eCollection 2021.
Calcified juxtafacet cysts in the cervical spine are extremely rate. Such symptomatic cysts commonly cause neck pain, radiculopathy, or even myelopathy. MR and CT studies typically document cord/ root compression. On occasion, some of these cysts will spontaneously regress, while many others may warrant surgical removal.
A 70-year-old male presented with a 2-year history of a progressive tetraparesis. The preoperative MR/CT studies showed a C1-C2 left extradural mass occupying more than half of the spinal canal. On MR, it was homogeneously hypointense on both T1- and T2-weighted images, while the CT showed a calcified cyst. Intraoperative and histopathological findings documented a calcified cervical juxtafacet cyst (i.e. ganglion subtype) that was fully excised without sequelae.
C1-C2 juxtafacet cervical cyst should be considered when a patient presents with myelopathy due to a calcified MR/CT documented paraspinal lesion contributing to significant cervical cord/root compression.
颈椎关节突钙化囊肿极为罕见。此类有症状的囊肿通常会导致颈部疼痛、神经根病,甚至脊髓病。磁共振成像(MR)和计算机断层扫描(CT)研究通常可记录脊髓/神经根受压情况。有时,其中一些囊肿会自行消退,而其他许多囊肿可能需要手术切除。
一名70岁男性,有2年进行性四肢轻瘫病史。术前MR/CT研究显示C1-C2左侧硬膜外肿块占据椎管一半以上。在MR上,其在T1加权和T2加权图像上均呈均匀低信号,而CT显示为钙化囊肿。术中及组织病理学检查结果证实为钙化性颈椎关节突囊肿(即神经节亚型),已完全切除且无后遗症。
当患者因MR/CT记录的钙化性椎旁病变导致严重颈椎脊髓/神经根受压而出现脊髓病时,应考虑C1-C2颈椎关节突囊肿。