Discal Cyst: a Rare Cause of Neurologic Compression in the Young Adult

Autores

  • André Nunes Machado Spine Surgeon Fellow ABC Medical School
  • Rodrigo Junqueira Nicolau Orthopaedic Assistent and Spine Surgeon at Albert Einstein Hospital
  • Joice Anaize Tonon do Amaral Orthopaedic Assistent and Spine Surgeon at Albert Einstein Hospital
  • Renata Salatini
  • Jiangyi Wu
  • Luciano Miller Reis Rodrigues Chief of Spine Surgery Group of ABC Medical School

DOI:

https://doi.org/10.7322/jhgd.119298

Palavras-chave:

intervertebral disc, minimally invasive surgical procedures, sciatica, back pain, intervertebral disc displacement, radiculopathy.

Resumo

Introduction: discal cysts are rare pathology. Its clinical presentation can be mistaken for disc herniation, with back pain, radiculopathy and neurological defi cit. It is more common in male patients in their fourth life decade. Because they are rare, there is no consensus about the treatment. A great variety of procedures, from medication for the pain to endoscopic or microdiscectomy excision, have been described. Objetive: Describe a case of discal cyst on the l4-l5 level with compression of l5 right nerve root treated successfully with a minimal invasive procedure. Study design: Case report. Methods: Review medical records, pertinent images, interview with the patient and surgical team, intraoperative and histopathological fi ndings. The surgical technique used was minimally invasive. Results: Magnetic resonance imaging (MRI) demonstrated a cystic lesion imaging at the level of the L4-L5 disc. The cystic mass displaced the thecal sac dorsally compressed the L5 transversing root. The patient was submitted to a minimally invasive microendoscopic technique using a tubular retractor. He recovered completely after the procedure, presenting absence of leg pain and went back to his regular activities 3 weeks after the surgery. Histopathological examination of the cyst revealed thick fi brous connective tissue interspersed with areas of chronic infl ammation. Conclusion: Discal cysts are rare intraspinal lesions. They can trigger severe neurological symptoms, and should be differentiated from other forms of epidural cysts and tumors. There are many treatment options that can be chosen from but no consensus. We used a treatment that was less invasive than the ones described in the literature.

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Publicado

2016-08-29

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