Recurrent intraneural ganglion cysts: Pathoanatomic patterns and treatment implications.

Autor: Desy NM; Department of Orthopedics, Mayo Clinic, Rochester, Minnesota., Lipinski LJ; Department of Neurosurgery, School of Medicine and Biomedical Sciences, University of Buffalo, State University of New York, Buffalo, New York., Tanaka S; Department of Neurosurgery, Faculty of Medicine, the University of Tokyo, Tokyo, Japan., Amrami KK; Department of Radiology, Mayo Clinic, Rochester, Minnesota., Rock MG; Department of Orthopedics, Mayo Clinic, Rochester, Minnesota., Spinner RJ; Department of Orthopedics, Mayo Clinic, Rochester, Minnesota.; Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota.; Department of Anatomy, Mayo Clinic, Rochester, Minnesota.
Jazyk: angličtina
Zdroj: Clinical anatomy (New York, N.Y.) [Clin Anat] 2015 Nov; Vol. 28 (8), pp. 1058-69. Date of Electronic Publication: 2015 Sep 09.
DOI: 10.1002/ca.22615
Abstrakt: The etiology of intraneural ganglion cysts has been poorly understood. This has resulted in the development of multiple surgical treatment strategies and a high recurrence rate. We sought to analyze these recurrences in order to provide a pathoanatomic explanation and staging classification for intraneural cyst recurrence. An expanded literature search was performed to identify frequencies and patterns in cases of intraneural ganglion cyst recurrences following primary surgery. Two univariate analyses were completed to identify associations between the type of revision surgery and repeat cyst recurrences. The expanded literature search found an 11% recurrence rate following primary surgery, including 64 recurrences following isolated cyst decompression (Group 1); six after articular branch resection (Group 2); and none following surgical procedures that addressed the joint (Group 3). Eight cases did not specify the type of primary surgery. In group 1, forty-eight of the recurrences (75%) were in the parent nerve, three involved only the articular branch, and one travelled along the articular branch in a different distal direction without involving the main parent nerve. In group 2, only one case (17%) recurred/persisted within the parent nerve, one recurred within a persistent articular branch, and one formed within a persistent articular branch and travelled in a different distal direction. Intraneural recurrences most commonly occur following surgical procedures that only target the main parent nerve. We provide proven or theoretical explanations for all identified cases of intraneural recurrences for an occult or persistent articular branch pathway.
(© 2015 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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