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[关节突囊肿作为椎管内占位性病变]

[Juxta-facet cysts as space-occupying intraspinal processes].

作者信息

Antoniadis G, Richter H P, Kast E, Treugut H

机构信息

Neurochirurgische Klinik der Universität Ulm, Günzburg.

出版信息

Nervenarzt. 1997 Jun;68(6):515-20. doi: 10.1007/s001150050155.

Abstract

Ganglionic and synovial cysts (juxta-facet cysts) causing nerve root compression are very rare. Magnetic resonance imaging is the best means of diagnosis. The treatment of choice is surgical removal of the cysts, though spontaneous remissions do occur. CT-guided aspiration of the cysts and corticosteroid injection can lead the symptoms to disappear, but only for a short time. In a retrospective study covering a period of 16.5 years, we discovered 24 juxta-facet cysts (10 ganglionic and 14 synovial cysts) with clinical symptoms in a total of 19,107 lumbar and thoracic operations performed to relieve nerve root compression: 16 cysts were located at the level L4-5,3 at the level L5-S1,2 at L3-4, and 1 each at the levels L2-3, L1-2, and T10-1. Seven patients complained of radicular pain, and the other 17 patients also had neurological deficits. Fourteen cysts were resected, and in 10 cases the lumbar disc was removed simultaneously. The average follow-up in 23 of the 24 patients was 26.6 months. Most (74%) of the patients became free of pain. Pareses disappeared in 89% and sensory deficits in 73% of cases.

摘要

导致神经根受压的神经节囊肿和滑膜囊肿(关节突囊肿)非常罕见。磁共振成像(MRI)是最佳诊断方法。尽管囊肿确实会自发缓解,但治疗的首选方法是手术切除囊肿。CT引导下囊肿抽吸和皮质类固醇注射可使症状消失,但仅能维持较短时间。在一项为期16.5年的回顾性研究中,我们在总共19107例为缓解神经根受压而进行的腰椎和胸椎手术中,发现了24例有临床症状的关节突囊肿(10例神经节囊肿和14例滑膜囊肿):16例囊肿位于L4 - 5水平,3例位于L5 - S1水平,2例位于L3 - 4水平,L2 - 3、L1 - 2和T10 - 1水平各有1例。7例患者主诉有神经根性疼痛,其他17例患者也有神经功能缺损。14例囊肿被切除,其中10例同时进行了腰椎间盘切除术。24例患者中的其中23例平均随访时间为26.6个月。大多数(74%)患者疼痛消失。89%的患者轻瘫消失,73%的患者感觉障碍消失。

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