Faculty of Medicine, Tartous University, Tartous, Syrian Arab Republic.
Department of Neurosurgery, Tartous University, Tartous, Syrian Arab Republic.
J Med Case Rep. 2024 Sep 16;18(1):432. doi: 10.1186/s13256-024-04762-2.
Spinal cysts have traditionally been treated with surgery since it was first described in 1950. However, there have been rare instances where these cysts have resolved on their own without the need for surgical intervention. Here, we discuss the 27th reported case of such spontaneous resolution in the medical literature and delve into the details of this unique case.
This report details a rare case of a 58-year-old Middle Eastern female who suffered from severe radicular and lumbar pain. Radiological study showed the presence of a cyst in the lumbar column. Noninvasive treatment was chosen after ensuring that there were no other symptoms requiring surgery. The patient showed gradual improvement over the course of 12 months, after which the pain completely disappeared.
The surgical approach is currently the main treatment for spinal cysts, but spontaneous resolution, despite its rarity, may be worth considering as a preferred therapeutic approach in the future. This avenue has not been thoroughly explored or studied. Due to the etiology of these cysts and their location within mobile joints, a longer period of conservative management including rest and physical therapy may play a pivotal role in promoting natural resolution.
Conservative treatment of cysts should continue for at least 8 months, using painkillers and physical therapy without lumbar bracing. Surgery remains the most effective means of treatment to date. Further research is needed to validate and establish standardized treatment protocols.
自 1950 年首次描述以来，传统上一直采用手术治疗脊柱囊肿。然而，也有极少数情况下，这些囊肿会自行消退，无需手术干预。在这里，我们讨论了医学文献中第 27 例此类自发性消退的病例，并深入探讨了这一独特病例的细节。
本报告详细介绍了一例罕见的 58 岁中东女性病例，该患者患有严重的神经根和腰痛。放射学研究显示腰椎存在囊肿。在确保没有其他需要手术的症状后，选择了非侵入性治疗。经过 12 个月的治疗，患者逐渐好转，疼痛完全消失。
目前手术是治疗脊柱囊肿的主要方法，但尽管自发性消退罕见，但将来可能值得考虑作为首选治疗方法。这一途径尚未得到充分探索或研究。由于这些囊肿的病因及其在活动关节内的位置，更长时间的保守治疗，包括休息和物理治疗，可能在促进自然消退方面发挥关键作用。
至少应持续 8 个月进行囊肿的保守治疗，使用止痛药和物理治疗，而不使用腰部支撑。手术仍然是迄今为止最有效的治疗方法。需要进一步研究以验证和建立标准化的治疗方案。
