Surgical Treatment of Lumbar Spinal Discal Cyst: Is It Enough to Remove the Cyst Only without Following Discectomy?
Autor: | Sang-Ryong Jeon, Jin Hoon Park, Sung Woo Roh, Seung-Chul Rhim, Byung-Jou Lee, Jung Won Park |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Cauda equina syndrome 030218 nuclear medicine & medical imaging Cystectomy Young Adult 03 medical and health sciences 0302 clinical medicine Lumbar Discectomy medicine Humans Spinal canal Cyst radiculopathy Retrospective Studies intervertebral disc cyst Lumbar Vertebrae Cysts business.industry Laminectomy microsurgery Middle Aged medicine.disease Low back pain Surgery Oswestry Disability Index Treatment Outcome medicine.anatomical_structure intervertebral disc disease Female Spinal Diseases Original Article intervertebral disc Neurology (clinical) medicine.symptom business 030217 neurology & neurosurgery Diskectomy |
Zdroj: | Neurologia medico-chirurgica |
ISSN: | 1349-8029 0470-8105 |
Popis: | 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. |
Databáze: | OpenAIRE |
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