Cyst of the Ligamentum Flavum: Report of Six Cases

Vernet, Olivier; Fankhauser, Heinz; Schnyder, P.; Déruaz, J. P.

doi:10.1227/00006123-199108000-00021

Cited by 62 publications

(44 citation statements)

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“…Continuous stress to the ligamentum flavum due to minor chronic trauma such as listhesis may predispose to the formation of the cyst [6]. Only in a few cases is the localization of cysts C6-C7, C3-C4 and C5-C6 levels [22]. However, in our case, the subluxation resolved after resection of the cyst, which may imply that the cyst, in contrary to what is reported, could be the primary event that caused the subluxation later.…”

Section: Discussionmentioning

confidence: 99%

Cervical cyst of the ligamentum flavum and C7-T1 subluxation: case report

et al. 2005

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IntroductionCysts of the ligamentum flavum are rare lesions that are most frequently located in the lumbar spine [1 -4, 21, 23], the cervical localization is unusual [11]. Most of the intraspinal degenerative cysts are juxta-articular (synovial and ganglion) cysts, and have a similar radiologic appearance [8,12,15,16,20]. We report the unique neuroimaging and pathological findings obtained in a patient with a cyst of the ligamentum flavum in the cervical region associated with a C7-T1 subluxation. This report, to our information, is the first of its kind. Case reportThis 66-year-old woman presented with a 1-year history of progressive gait disturbance with lower extremity fatigue. Clinical examination revealed marked spastic paraparesis and difficulty in performing fine motor tasks with the left hand as well as loss of penmanship of the right hand. MRI revealed a T2-hyperintense cystic lesion with a hypointense tail in the anterolateral part of the left lamina of C7 (Fig. 1a), associated with a C7-T1 anterolisthesis (Fig. 1b). The patient underwent a C7-T1 hemilaminectomy and a hypertrophied, partially calcified ligamentum was resected. A round, yellowish cyst of about 1 cm in diameter filled with gelatinous fluid was found in the internal aspect of the ligamentum flavum; it was adherent to the duramater but dissection was achieved easily. There was no communication between the lumen of the cyst and the joint capsule. Pathological examination of the cyst revealed myxoid and pseudocystic degeneration of the ligamentum flavum without a synovial layer (Fig. 2). A postoperative dynamic X-ray revealed no spinal instability with resolution of the cervicothoracic subluxation. The patient's myelopathy Abstract A patient with progressive gait disturbance resulting from a cyst of the cervical ligamentum flavum associated with C7-T1 listhesis is reported. Surgical removal of the cyst improved the patient's myelopathy. Intraspinal degenerative cysts are preferentially located in the lumbar region:unusual is the cervical localization. Differential diagnosis includes ligamentum flavum cyst, synovial and ganglion cysts. Association between degenerative intraspinal cysts and listhesis is discussed. To our knowledge, this is the first case of cyst of the ligamentum flavum associated with cervical subluxation.

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Section: Discussionmentioning

confidence: 99%

Cervical cyst of the ligamentum flavum and C7-T1 subluxation: case report

et al. 2005

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“…18,28) The overall prevalence of anterior and posterior facet joint cysts are 2.3% and 7.3%, respectively, and back pain is the primary symptom for cysts located posterior to the facet joint, possibly because the ligamentum flavum (LF) acts as a mechanical barrier against the formation of anterior cysts. 7) Synovial cysts within the lumbar spinal canal are usually classified as synovial cyst, ganglion cyst, posterior longitudinal ligament (PLL) cyst, or LF cyst based on their location, 9) origin, 1,34) and pathologic features. 14) Cystic lesion located on the internal and posterolateral side of the spinal canal, continuous with the facet joints, and lined with epithelial tissue is classified as synovial cyst.…”

Section: Introductionmentioning

confidence: 99%

“…28,29) Cystic lesion located at the periarticular area but lacking epithelial lining and continuity with the synovial cavity is classified as ganglion cyst. 28) Cystic lesion embedded in the inner surface of the LF with no epithelial lining or continuity with the facet joint synovium is classified as LF cyst, 1,34) and cystic lesion located in the PLL with the same properties is classified as PLL cyst. 21) These lesions usually present with common symptoms of radiculopathy, neurogenic claudication, myelopathy, neurological deficit, and even cauda equina syndrome.…”

Section: Introductionmentioning

confidence: 99%

Lumbar Synovial Cysts: Experience With Nine Cases

Ayberk

Ozveren

Gok

et al. 2008

Neurol. Med. Chir.(Tokyo)

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Nine patients treated surgically for lumbar spinal synovial cyst were reviewed. Four patients had synovial, two had ganglion, one had posterior longitudinal ligament, and two had ligamentum flavum cyst. Synovial cysts had a single layer of epithelial cells in the inner layer of the cyst with continuity with the facet joint. Ganglion cyst had no continuity with the facet joint and epithelial lining was present in one and absent in one case. Posterior longitudinal ligament and ligamentum flavum cysts had no continuity with the facet joint and no epithelial lining. Magnetic resonance imaging showed the cysts better than computed tomography. All patients treated for nerve root compression or lumbar spinal canal narrowing. One patient suffered recurrence 1 year later and was reoperated. Operative results were excellent in six and good in three patients. Lumbar spinal synovial cysts should be considered in differential diagnosis of lumbar radiculopathy/neurogenic claudication and is surgically treatable.

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“…Trauma has been implicated in the development of ganglion cysts of the PLL 4) , which mainly occur in young, athletic men with a history of recurrent injuries. Extradural lumbar spinal cystic lesions are usually classified as synovial cyst, ganglion cyst, PLL or LF cyst based on their location 6) , origin, 1,21) and pathologic features 7) . All these lesions are hypointense on T1, hyperintense on T2, and frequently rim enhanced after intravenous gadolinium administration 13) .…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, a spinal extradural cyst is a rare cause of such radiculopathy. Extradural cysts within the lumbar spinal canal are usually classified as synovial cyst, PLL cyst, or ligament flavum (LF) cyst based on their location 6) , origin 1,21) , and pathologic freatures 7) . Cystic lesion located in the PLL but lacking epithelial lining and continuity with the PLL is classified as PLL cyst.…”

Section: Introductionmentioning

confidence: 99%

Ganglion Cyst of the Posterior Longitudinal Ligament Causing Lumbar Radiculopathy

Cho

Rhee

Lee

et al. 2010

J Korean Neurosurg Soc

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J Korean Neurosurg Soc 47 : [298][299][300][301] 2010 Degenerated conditions such as herniated disc or spinal stenosis are common etiologies of lumbar radiculopathy. Less common etiologies include spinal extradural cyst such as synovial cysts and ganglion cysts. Ganglion cyst of the posterior longitudinal ligament (PLL) of the spine is a rare entity that can result in classical sciatica. Posterior longitudinal ligament cyst has no continuity with the facet joint and has no epithelial lining. Two young male patients presented with unilateral sciatica and were found to have intraspinal cystic lesions causing lumbar radiculopathy. Magnetic resonance imaging demonstrated rounded, cystic lesions (i.e., hypointense on T1-but hyperintense on T2-weighted images) adjacent to minimally dehydrated, nonherniated disc spaces in both cases. These patients underwent posterior decompression and cysts were excised, and their sciatic symptoms were completely resolved. Histological examination showed typical features of ganglion cysts in these cases.

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Cyst of the Ligamentum Flavum: Report of Six Cases

Cited by 62 publications

References 0 publications

Cervical cyst of the ligamentum flavum and C7-T1 subluxation: case report

Cervical cyst of the ligamentum flavum and C7-T1 subluxation: case report

Lumbar Synovial Cysts: Experience With Nine Cases

Ganglion Cyst of the Posterior Longitudinal Ligament Causing Lumbar Radiculopathy

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