Kido Yuki, Kamei Naosuke, Fujioka Yuki, Nakamae Toshio, Adachi Nobuo, Sasaki Masanobu
Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Department of Orthopaedic Surgery, JR Hiroshima Hospital, Hiroshima, Japan.
Int J Spine Surg. 2023 Jun;17(3):407-417. doi: 10.14444/8440. Epub 2023 Feb 24.
Juxtafacet cysts are located near or contiguous with the facet joints, and their occurrence is rare in the cervical spine. We report 4 cases of cervical juxtafacet cysts operated by microcervical foraminotomy (MCF) or a combination of MCF and laminoplasty. We simultaneously review previously reported cases in terms of location, clinical findings, and surgical technique.
Among the patients who underwent spine surgery at our hospital from 2015 to 2019, 4 had cervical juxtafacet cysts. The images and clinical records of the patients were retrospectively assessed. Relevant previous English literature was searched and reviewed using PubMed.
In our series, all 4 patients presented with unilateral upper extremity muscle weakness preoperatively. Two patients underwent MCF, and the other 2 underwent a combination of MCF and laminoplasty with resection of the cyst. All showed improvement in muscle strength. In previously reported cases, the rate of muscle weakness was high. A review of previous cases showed that 75 of 139 patients had cysts at C7-T1. The most common surgical techniques consisted of a hemilaminectomy or laminectomy with the addition of posterior fusion in 28 patients. The number of male patients was twice that of female patients; however, the male-to-female ratio was almost the same in patients with cysts in C7-T1. On pathological diagnosis, there were 3 times more synovial cysts than ganglion cysts. The percentage of synovial cysts was higher in patients with radiculopathy, and the percentage of ganglion cysts was higher in patients with myelopathy.
Cervical juxtafacet cysts tend to occur in C7-T1 and cause muscle weakness. Surgical therapy is strongly recommended due to good postoperative improvement.
The results of this study suggest that microcervical foraminotomy for cervical juxtafacet cysts can provide favorable symptomatic improvement.
关节突旁囊肿位于关节突关节附近或与之相邻，在颈椎中其发生率较低。我们报告4例经微颈椎孔切开术（MCF）或MCF与椎板成形术联合治疗的颈椎关节突旁囊肿病例。我们同时从囊肿位置、临床表现及手术技术方面对既往报道的病例进行综述。
在我院2015年至2019年接受脊柱手术的患者中，有4例患有颈椎关节突旁囊肿。对患者的影像资料和临床记录进行回顾性评估。使用PubMed检索并回顾相关的既往英文文献。
在我们的病例系列中，所有4例患者术前均表现为单侧上肢肌无力。2例患者接受了MCF，另外2例接受了MCF与椎板成形术联合囊肿切除术。所有患者肌力均有改善。在既往报道的病例中，肌无力发生率较高。对既往病例的回顾显示，139例患者中有75例囊肿位于C7 - T1。最常见的手术技术包括28例患者行半椎板切除术或椎板切除术并加用后路融合术。男性患者数量是女性患者的两倍；然而，C7 - T1囊肿患者的男女比例几乎相同。病理诊断显示，滑膜囊肿数量是腱鞘囊肿的3倍。神经根病患者中滑膜囊肿的比例较高，脊髓病患者中腱鞘囊肿的比例较高。
颈椎关节突旁囊肿倾向于发生在C7 - T1并导致肌无力。鉴于术后改善良好，强烈推荐手术治疗。
本研究结果表明，微颈椎孔切开术治疗颈椎关节突旁囊肿可使症状得到良好改善。
