Galibert P, Estefan G, Le Gars D, Sevestre H, Gonthier M, Grunewald P, Rosat P
Neurochirurgie. 1983;29(6):377-80.
Synovioma, a benign neoplasm arising from pigmented villonodular synovium or synovitis, is uncommon. It involves the tendons and joints of the finger, ankle and foot. In this study four cases of villonodular synovioma of spinal joints are reported. The authors studied 555 cases of patients operated for sciatica due to herniated disk. Histopathology showed that in four out of 555 cases sciatica was found to be due to synoviomas of the spinal joints. The patients, three women and one man, were between 54 and 70 years of age and each had had a long history of low back pain with episodes of sciatica. Clinical evaluation at the time of surgery showed moderate severity of signs and symptoms. Roentgenographic studies of all four cases revealed osteoarthritic changes of vertebral apophyses, with two cases of spondylolisthesis. The pathogenesis of synovioma remains controversial and its histopathological characterization -hyperplasia VS/true tumours- has not yet been determined. It is possible that the number of recorded cases of sciatica due to synoviomas is small because surgical and pathological studies in patients with sciatica associated with osteoarthritic changes have not been adequately performed. Surgery consists of a large resection of the capsule and ligament including resection of intraspinal extension. Because this study involves only four cases, the first of which occurred in 1977, the possibility of recurrence cannot be evaluated.
滑膜瘤是一种起源于色素沉着绒毛结节性滑膜炎或滑膜炎的良性肿瘤，较为罕见。它累及手指、踝关节和足部的肌腱和关节。在本研究中，报告了4例脊柱关节绒毛结节性滑膜炎病例。作者研究了555例因椎间盘突出症接受坐骨神经痛手术的患者。组织病理学显示，在555例病例中，有4例坐骨神经痛是由脊柱关节滑膜瘤引起的。患者为3名女性和1名男性，年龄在54至70岁之间，均有长期下背痛伴坐骨神经痛发作史。手术时的临床评估显示体征和症状为中度严重程度。所有4例患者的X线检查均显示椎体附件有骨关节炎改变，其中2例有椎体滑脱。滑膜瘤的发病机制仍存在争议，其组织病理学特征——增生与真性肿瘤——尚未确定。由于对伴有骨关节炎改变的坐骨神经痛患者的手术和病理研究尚未充分开展，因滑膜瘤导致的坐骨神经痛的记录病例数可能较少。手术包括广泛切除包膜和韧带，包括切除椎管内延伸部分。由于本研究仅涉及4例病例，其中第一例发生于1977年，因此无法评估复发的可能性。
