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Lumbar spinal cysts

Anand Kaul, Sunil Manjila, Jonathan P Miller
: Isadore Max Tarlov (1905-1977) is primarily remembered for his 1938 description of the eponymous perineural "Tarlov cyst." However, during his long career as a neurosurgeon and researcher, he was responsible for many other observations and inventions that influenced the development of neurosurgery in the 20th century. While studying at Johns Hopkins Medical School he was acquainted with Walter Dandy, and he became the first resident to study under Wilder Penfield at the newly formed Montreal Neurological Institute...
November 2016: Neurosurgery
Javier Quillo-Olvera, Javier Quillo-Reséndiz, Carlos-Francisco Gutiérrez-Partida, Manuel Rodríguez-García
BACKGROUND: Arachnoid cysts of spine are a very rare occurrence. The aetiology still remains unclear, but the most accepted explanation is the existence of areas of weakness in the spinal dura. Symptoms depend on the location in the spine. Magnetic resonance imaging is used for its diagnosis. Management depends of clinical presentation, and the surgery is reserved for patients with neurological impairment. CLINICAL CASE: A case is described of 67 year-old male with myelopathy and radiculopathy symptoms, both diagnosed simultaneously...
October 14, 2016: Cirugia y Cirujanos
O Lista-Martínez, V M Moreno-Barrueco, J Castro-Castro, P Varela-Rois, A Pastor-Zapata
INTRODUCTION: Although they are freqqently described in the literature, lumbar synovial cysts are a relative uncommon cause of low back and radicular leg pain. OBJECTIVE: To evaluate the treatment and surgical outcomes of the lumbar synovial cysts operated on in our hospital during a 5 year period. MATERIAL AND METHODS: A retrospective study was conducted on patients surgically treated in our department from August 2009 to September 2014, using a visual analogue scale for the clinical follow-up in the first year after surgery...
October 4, 2016: Revista Española de Cirugía Ortopédica y Traumatología
Peter C Emary, John A Taylor
Perineural (Tarlov) cysts are rare and are usually asymptomatic and an incidental finding on routine spinal imaging. Presented here is a case of sciatic neuralgia in a 56-year-old patient whose clinical symptoms correlated with a lower lumbar perineural cyst.
September 2016: Journal of the Canadian Chiropractic Association
Samia Frioui Mahmoudi, Mohamed Layeb, Saoussen Layouni, Sonia Jemni, Mariem Gaddour, Khalil Ben Jeddou, Faycel Khachnaoui
OBJECTIVE: Our goal is to study through this observation and review of the literature the role of Tarlov cyst in the occurrence of lombosciatalgias and therapeutic possibilities. OBSERVATIONS: Mrs. H.M 48 years old, with no notable medical history, is hospitalized in Physical Medicine and Functional Rehabilitation department CHU Sahloul for a right S1 radiculopathy associated with a subjective feeling of lower extremity weakness evolving for one year. Clinical examination found a spinal syndrome, absence of discoradicular conflict signs and a plantar flexion deficit of the right ankle...
September 2016: Annals of Physical and Rehabilitation Medicine
Yashar Eshraghi, Vimal Desai, Calvin Cajigal Cajigal, Kutaiba Tabbaa
BACKGROUND: Lumbar synovial cysts can result from spondylosis of facet joints. These cysts can encroach on adjacent nerve roots, causing symptoms of radiculopathy. Currently the only definitive treatment for these symptoms is surgery, which may involve laminectomy or laminotomy, with or without spinal fusion. Surgery has been reported to successfully relieve radicular pain in 83.5% of patients by Zhenbo et al. Little information is available concerning the efficacy and outcome of percutaneous fluoroscopic synovial cyst rupture for treatment of facet joint synovial cysts...
September 2016: Pain Physician
Toshihiko Nishisho, Toshinori Sakai, Fumitake Tezuka, Kosaku Higashino, Shoichiro Takao, Yoichiro Takata, Ryo Miyagi, Shunichi Toki, Mitsunobu Abe, Kazuta Yamashita, Akihiro Nagamachi, Koichi Sairyo
Background Symptoms of primary bone and soft tissue tumors located in the trunk mimic those of degenerative spinal disorders such as low back pain or pain or numbness of the legs. Due to their rarity, especially in sarcoma located in the trunk, diagnosis is sometimes delayed. Methods A retrospective review was performed of the records of 383 patients with primary bone and soft tissue tumors who visit our out patient clinic from 2011 to 2013 at a single institution. Patients with delayed diagnosis of primary bone and soft tissue tumors initially treated as degenerative spinal disorders for more than 2 months were identified...
2016: Journal of Medical Investigation: JMI
M K Ahsan, N Sakeb, M Y Ali, M A Awwal, S I Khan, M M Goni, M B Mia, M B Alam, N Zaman, S N Jannat
Results of 63 surgically treated intradural spinal tumors between the period of October 2003 and December 2014 at Bangabandhu Sheikh Mujib Medical University (BSMMU) and in our private settings, Dhaka, were analyzed retrospectively. There were 33 males, 30 females with an average age of 52.4 years (13-70 years) and followed up for at least a year. The preoperative symptom with duration, tumors location and intradural space occupancy and the histopathological diagnosis were analyzed. Pain was evaluated by the visual analogue scale (VAS) and the neurologic function was assessed by Nurick's grade...
July 2016: Mymensingh Medical Journal: MMJ
Dae-Jung Choi, Chang-Myong Choi, Je-Tea Jung, Sang-Jin Lee, Yong-Sang Kim
STUDY DESIGN: Descriptions of technical strategies to overcome pitfalls associated with early learning periods in biportal endoscopic spinal surgery (BESS). PURPOSE: To introduce BESS for lumbar spinal diseases (LSDs) and to inform certain challenges to be overcome in mastering the technique. OVERVIEW OF LITERATURE: BESS has shown superior benefits including excellent magnification, a wider range of view by dynamic handling of an endoscope and instruments...
August 2016: Asian Spine Journal
Toru Funayama, Alessandro Gasbarrini, Riccardo Ghermandi, Marco Girolami, Stefano Boriani
PURPOSE: We describe a rare case of solitary bone cyst involving the vertebral body of L4. INTRODUCTION: To the best of the authors' knowledge, only 15 cases of solitary bone cysts involving the spine have been reported previously. All the reported cases were treated surgically, including resection and curettage with or without bone grafting. In the current case, treatment was with steroid injection alone. METHOD: A cystic lesion involving the vertebral body of L4 was identified in a 16-year-old girl with persistent low back pain of 2 years' duration...
August 23, 2016: European Spine Journal
David J Wang, Stephen P Lownie, David Pelz, Sachin Pandey
Spinal synovial cysts are benign protrusions of facet joint capsules caused by degenerative spondylosis, most frequently involving the L4-5 level, and commonly lead to symptoms of back pain, radiculopathy and neurogenic claudication. Although percutaneous treatment via facet joint steroid injection with cyst rupture can provide significant symptom relief, cyst rupture is not always achievable via an indirect trans-facet approach due to limited access from severe degenerative changes. In this case, we describe a successful approach to direct cyst access using a laser-guided navigational software in a patient with severe facet joint osteophytosis...
October 2016: Interventional Neuroradiology
Nancy Ellen Epstein
BACKGROUND: Few reoperations are required in older patients undergoing multilevel lumbar laminectomy with noninstrumented fusions for spinal stenosis with/without spondylolisthesis/instability, and they rarely require instrumentation. METHODS: We reviewed 336 patients averaging 66.5 years of age undergoing initial average 4.7 level lumbar laminectomies with average 1.4 level noninstrumented fusions over an average 7.1-year period (range 2.0-16.5 years). Patients uniformly exhibited spinal stenosis, instability (Grade I [195 patients] or Grade II spondylolisthesis [67 patients]), disc herniations (154 patients), and/or synovial cysts (66 patients)...
2016: Surgical Neurology International
Akira Miyauchi, Tadayoshi Sumida, Mayumi Kaneko, Hideki Manabe, Nobuo Adachi
PURPOSE: Compared to the ligamentum flavum (LF), morphology of the epidural membrane (EM) and the periradicular fibrous tissue (PRFT) has been largely ignored in studies of lumbar spinal stenosis (LSS). The aim of this prospective study was to elucidate the morphologies and clinical importance of the EM and PRFT in LSS. METHODS: Before starting this study, neural compressive EM (c-EM) and PRFT (c-PRFT) were defined as follows based on our microsurgical experience and a literature review...
June 7, 2016: European Spine Journal
Satoko Kojima, Junichi Yoshimura, Tetsuro Takao, Tetsuro Tamura, Kenichi Nishiyama, Shigeru Maruyama, Masashi Suda, Yukihiko Fujii
The authors report the case of a mobile spinal enterogenous cyst in a 2-year-old boy, who was admitted to the hospital several times for intermittent paraplegia. Magnetic resonance imaging and CT revealed an isolated cyst in the lumbar spinal canal. The symptoms were caused by transient myelopathy of the conus medullaris and radiculopathy of the cauda equina due to the changing size and location of the cyst. The cyst was surgically extirpated, after which the symptoms resolved. The histopathological diagnosis was enterogenous cyst...
June 3, 2016: Journal of Neurosurgery. Pediatrics
Felix E Diehn, Timothy P Maus, Jonathan M Morris, Carrie M Carr, Amy L Kotsenas, Patrick H Luetmer, Vance T Lehman, Kent R Thielen, Ahmad Nassr, John T Wald
Beyond the familiar disk herniations with typical clinical features, intervertebral disk pathologic conditions can have a wide spectrum of imaging and clinical manifestations. The goal of this review is to illustrate and discuss unusual manifestations of intervertebral disk pathologic conditions that radiologists may encounter, including disk herniations in unusual locations, those with atypical imaging features, and those with uncommon pathophysiologic findings. Examples of atypical disk herniations presented include dorsal epidural, intradural, symptomatic thoracic (including giant calcified), extreme lateral (retroperitoneal), fluorine 18 fluorodeoxyglucose-avid, acute intravertebral (Schmorl node), and massive lumbar disk herniations...
May 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Eli M Baron, Diana M Mejía, Doniel Drazin, Neel Anand
Bone morphogenetic protein use in spinal surgery for off-label indications continues to remain popular. One area where its use has known associated radicular complications is posterior or transforaminal lumbar interbody fusion. These complications include radiculitis, cyst development, and heterotopic ossification, amongst others. Typically, cyst development has been treated surgically. We present two cases of bone morphogenetic protein-related cysts treated medically and thus, present medical treatment as an alternative treatment option...
2016: Curēus
S Rajasekaran, Siddharth N Aiyer, Ajoy Prasad Shetty, Rishi Kanna, Anupama Maheswaran
PURPOSE: Aneurysmal bone cysts (ABC) form 1 % of primary bone tumors. Reported incidence rates are no more than 1.4 to 1,00,000. ABC of spine frequently involves posterior elements and commonly affects the lumbar spine (45 %). We present a case of C2 ABC for the challenges it poses due to the rarity of the lesion, tedious to access location, dilemmas relating to the suitable approach for tumor resection and technically demanding stabilization and reconstruction strategy post resection...
March 23, 2016: European Spine Journal
Melissa Valdez Quintana, Jean Michaud, Darine El-Chaar, Dina El Demellawy, Sarah M Nikkel, Elka Miller
Segmental spinal dysgenesis (SSD) is a rare congenital spinal abnormality characterized by segmental dysgenesis or agenesis of the thoracolumbar or lumbar spine, congenital kyphosis, and abnormal configuration of the underlying spinal cord. A unique feature of SSD is that the vertebrae are present above and below the defect, and there is often a lower cord segment in the caudal spinal canal. We report a fetal MRI case of SSD with postmortem and neuropathological correlations. Our report confirms already published findings including the presence of a neurenteric cyst but is the first to document anterior spinal artery segmental agenesis in SSD...
August 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Haitham El-Beltagy Abd El-Kader
STUDY DESIGN: This was a retrospective study. PURPOSE: To study the surgical outcome of synovial cysts of the lumbar spine through posterior laminectomy in combination with transpedicular screw fixation. OVERVIEW OF LITERATURE: Synovial cysts of the lumbar spine contribute significantly to narrowing of the spinal canal and lateral thecal sac and nerve root compression. Cysts form as a result of arthrotic disruption of the facet joint, leading to degenerative spondylolisthesis in up to 40% of patients...
February 2016: Asian Spine Journal
Xuesheng Zheng, Shiting Li, Hansong Sheng, Baohui Feng, Nu Zhang, Chaoran Xie
OBJECTIVE: Tarlov cyst is an abnormal expansion of the spinal nerve sleeve, and it communicates with the subarachnoid cavity via a perineural fistula. This study presents our experience of a balloon-assisted fistula sealing procedure in treating Tarlov cyst. METHODS: Twenty-two patients with symptomatic Tarlov cysts were surgically treated. An emulsion balloon was placed into the lumbar subarachnoid cistern through a trocar, so as to temporarily block cerebrospinal fluid flow, then the thecal sac was opened and the inlet of the fistula was sealed by suture of a muscular patch and reinforced by fibrin glue...
April 2016: World Neurosurgery
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