Kang Sang-Soo, Kim Seung-Kook, Nelliyan Sivakumar, Lee Su-Chan
Orthopedics. 2023 Mar-Apr;46(2):e125-e128. doi: 10.3928/01477447-20220831-02. Epub 2022 Sep 7.
Perineural (Tarlov) cysts are a common benign pathology in the lumbosacral area but are rarely symptomatic, even when compressing the spinal root. Despite the rarity of Tarlov cyst formation in the foramen of the spine, this type is more symptomatic than those in other sites due to the narrow space. We introduce a biportal endoscopic fenestration for symptomatic foraminal Tarlov cysts. We present the case of a 40-year-old woman experiencing radiating pain in her right lower leg for 4 years. On seeking treatment, her great toe and ankle plantar flexion power had decreased. Magnetic resonance imaging revealed a cystic mass located in the L5-S1 intervertebral foramen that compressed the lumbar nerve root. Partial laminotomy was performed using a percutaneous biportal endoscopic system with a far lateral approach. An oval cystic mass of 2.6×1.1 cm was identified on high-definition images. Partial bone and foraminal ligament removal and cystic membrane fenestration were performed for nerve decompression. After decompression, the patient's motor weakness and radiating pain improved. Due to high-definition images and the minimally invasive laminotomy procedures associated with percutaneous biportal endoscopic fenestration, a foraminal Tarlov cyst was fenestrated safely, and weakness arising from radiculopathy was resolved in the current case. [. 2023;46(2):e125-e128.].
神经周围（塔尔洛夫）囊肿是腰骶部常见的良性病变，但很少有症状，即使压迫脊神经根时也是如此。尽管脊柱椎间孔中形成塔尔洛夫囊肿的情况罕见，但由于空间狭窄，这种类型比其他部位的囊肿更易出现症状。我们介绍一种用于有症状的椎间孔塔尔洛夫囊肿的双孔道内镜开窗术。我们报告一例40岁女性，右小腿放射性疼痛4年。就诊时，其拇趾和踝关节跖屈力量减弱。磁共振成像显示L5 - S1椎间孔有一囊性肿物，压迫腰神经根。采用经皮双孔道内镜系统经远外侧入路进行部分椎板切除术。在高清图像上发现一个2.6×1.1厘米的椭圆形囊性肿物。进行部分骨质和椎间孔韧带切除及囊肿壁开窗以行神经减压。减压后，患者的运动无力和放射性疼痛有所改善。由于高清图像以及与经皮双孔道内镜开窗术相关的微创椎板切除手术，在本例中安全地对椎间孔塔尔洛夫囊肿进行了开窗，神经根病引起的无力症状得到缓解。[. 2023;46(2):e125 - e128.]
