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

Yu, Hyun Jeong; Park, Chan‐Jin; Yim, Kyoung Hoon

doi:10.3344/kjp.2016.29.2.129

Cited by 16 publications

(16 citation statements)

References 22 publications

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“…Although discal cysts have been reported to occur in the intraspinal extraepidural area, 1,2,5 this is a rare case caused by the entry pathway of the PED on the intervertebral disc. The pathogenesis and etiology are still unclear.…”

Section: Discussionmentioning

confidence: 92%

“…Although there are a few reports of lesions that resolved with conservative therapy, good outcomes and low recurrence rates have been obtained in most cases through aspiration and surgical treatment, such as microendoscopic discectomy and PED. 5,10,11 Although it is possible that PED will not be able to completely resect the cyst, symptoms may be alleviated by decompression of the cyst contents and the intervertebral disc. Furthermore, the potential for recurrence can be reduced by annuloplasty using radiofrequency coagulation.…”

Section: Discussionmentioning

confidence: 99%

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A Rare Case of a Discal Cyst Following Percutaneous Endoscopic Lumbar Discectomy via a Transforaminal Approach

2019

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A discal cyst is a rare lesion that causes low back pain and radiculopathy of the lower extremities. There are several reports of discal cysts occurring after surgery, but data are limited on their occurrence after percutaneous endoscopic discectomy (PED). A 21-year-old man with disc herniation at the L4-L5 disc level underwent PED via a transforaminal approach. The immediate postoperative course was uneventful and his symptoms were relieved. Six weeks after surgery, low back pain and mild pain in the left thigh recurred. Magnetic resonance imaging (MRI) revealed a cystic lesion adjacent to the left side of the L4-L5 intervertebral disc. Conservative treatment was ineffective, so we reoperated using PED with the same approach. Pain improved and MRI revealed disappearance of the cystic lesion. When symptoms relapse after PED, it is necessary to consider the occurrence of a cyst.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

A Rare Case of a Discal Cyst Following Percutaneous Endoscopic Lumbar Discectomy via a Transforaminal Approach

2019

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“…We summarized previous literature on discal cyst treatment and compiled the data (Table 4). 1–4,7,10,11,17,19–48) For patients with tolerable pain or without neurologic deficits, the literature suggests conservative treatment for discal cysts, initially. 4,6,45) Conservative management options include bed rest, analgesics, physical therapy, percutaneous steroid injection, and image-guided cyst aspiration.…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment of Lumbar Spinal Discal Cyst: Is It Enough to Remove the Cyst Only without Following Discectomy?

Lee

Jeon

Rhim

et al. 2019

Neurol. Med. Chir.(Tokyo)

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Discal cysts are a rare cause of low back pain and radiculopathy with unknown pathophysiologic mechanism. Associated symptoms are difficult to distinguish from those caused by extruded discs and other spinal canal lesions. Most discal cysts are treated surgically, but it is unclear whether the corresponding intervertebral disc should be excised along with cyst. We conducted a retrospective clinical review of 27 patients who underwent discal cyst excision at our institution between 2000 and 2017. The mean follow-up period was 63.6 months. We recorded symptoms, radiographs, operative findings, postoperative complications, and short- and long-term outcomes. Structured outcome assessment was based on Numeric Rating Scale (NRS) for pain intensity, Oswestry disability index, and Macnab classification. All patients underwent partial hemilaminectomy and microscopic cyst resection without discectomy. All patients had preoperative back or leg pain. Other preoperative clinical features included motor weakness, neurogenic intermittent claudication, and cauda equina syndrome. After surgery, NRS scores of back and leg pain decreased. The other symptoms also improved. During long-term follow-up, patients reported no restrictions on daily life activities, and were satisfied with our intervention. There were no cases of cyst recurrence. We conducted a review of the literature on lumbar discal cysts published before January, 2018. Including our cases, 126 patients were described. We compared two surgical modalities—cystectomy with and without discectomy—to elucidate both effectiveness and long-term complications. We found that microsurgical cystectomy without corresponding discectomy is an effective surgical treatment for lumbar discal cysts, and is associated with a low recurrence rate.

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“…18 , 19 A study reported that they are accessible to each other. 24 Therefore, we should pay close attention to FJI like other treatments.…”

Section: Discussionmentioning

confidence: 99%

The effect of facet joint injection on lumbar spinal stenosis with radiculopathy

et al. 2018

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Objectives:Facet Joint Injection (FJI) is known to be effective in axial back pain, but the purpose of this study was to assess the effects of FJI on patients treated with it among those with Lumbar Spinal Stenosis (LSS).Methods:We conducted a retrospective database analysis and investigated electronic medical records of 125 LSS patients treated with FJI in the pain clinic of Chungbuk National University Hospital from November 2, 2016 to July 31, 2017. Sex, age, histories of low back surgery, complaining of neurogenic claudication, symptomatic sites of patients, FJI sites, number of sites of FJI, triamcinolone dosage, Numeric Rating Scale (NRS) before and after treatment, facet joint capsule rupture during treatment, and improvement of neurogenic claudication after treatment, were examined.Results:Among 125 patients, we investigated 91 patients who met the criteria. There was significant difference in NRS before and after treatment (p<0.000). Forty one patients with reduction of NRS more than 30% after FJI were allocated to effect group. FJI was more effective in patients who did not have the surgery (p=0.044), as well as those who showed an improved neurogenic claudication after treatment (p=0.001). Other measured values did not show statistical significances.Conclusions:FJI has relatively a lower risk and is simpler in terms of techniques than other interventional treatments performed within the spinal canal. Therefore, FJI may be another interventional treatment option in patients with pain by LSS. In the future, studies for FJI indication in LSS patients should be additionally required.

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

Cited by 16 publications

References 22 publications

A Rare Case of a Discal Cyst Following Percutaneous Endoscopic Lumbar Discectomy via a Transforaminal Approach

A Rare Case of a Discal Cyst Following Percutaneous Endoscopic Lumbar Discectomy via a Transforaminal Approach

Surgical Treatment of Lumbar Spinal Discal Cyst: Is It Enough to Remove the Cyst Only without Following Discectomy?

The effect of facet joint injection on lumbar spinal stenosis with radiculopathy

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