Radiculopathy Caused by Discal Cyst

Abstract

Sae Young KimDiscal cyst is an intraspinal cyst with a distinct communication with the corresponding intervertebral disc. It is a rare condition and could present with radiculopathy similar to that caused by lumbar disc herniation. We present a patient with a large discal cyst in the ventrolateral epidural space of the 5 th lumbar vertebral (L5) level that communicated with the adjacent 4 th lumbar and 5 th lumbar intervertebral disc, causing L5 radiculopathy. We alleviated the radiating pain with selective transforaminal epidural blocks. (Korean J Pain 2014; 27: 86-89)

Successful Treatment of a Symptomatic Discal Cyst by Percutaneous C-arm Guided Aspiration

“…Demaerel et al [ 22 ] also reported cyst regression without surgery or other interventional therapy, while Chou et al [ 8 ] reported spontaneous regression of a discal cyst during observation for symptomatic improvement after an epidural injection and selective nerve root block. Furthermore, a case in Korea also reported demonstrated dramatic improvement in discal cyst-related symptoms after a transforaminal epidural injection [ 7 ]. Because the natural history of discal cysts remains unknown, it is best to determine the treatment options on a case-by-case basis, with consideration of the patient's symptoms, rather than by performing surgery or a procedure immediately after diagnosis.…”

“…Surgical excision is usually the first-line treatment for discal cysts [ 1 2 3 4 5 ]. However, alternative treatment methods like computed tomography (CT)-guided aspiration and steroid injection or transforaminal epidural injection have been suggested; in some cases symptoms have improved with alternative treatments [ 6 7 8 ].…”

Percutaneous Endoscopic Discectomy via Transforaminal Route for Discal Cyst

“…Clinically, it is almost impossible to distinguish discal cyst from other causes of low back pain with radiculopathy (e.g., HNP, perineural cyst, extradural arachnoid cyst, and cystic schwannoma) [ 1 – 4 ]. In general, most patients with discal cyst are relatively young and active and are predominantly male [ 1 ].…”

“…Discal cysts are a rare cause of low back pain and radiculopathy, occurring in relatively young individuals [ 1 – 4 ]. Discal cysts are defined as intraspinal extradural cysts with distinct communication with the corresponding intervertebral disc [ 1 , 3 , 5 ].…”

“…The literature describes various treatments for discal cyst, from conservative to surgical excision [ 1 , 4 ]. Percutaneous endoscopic discectomy (PED) is a minimally invasive technique especially for avoiding damage to the back muscles [ 5 – 7 ].…”