Microendoscopic Resection of Lumbar Discal Cysts

Abstract

Introduction: A lumbar discal cyst is a relatively rare cystic lesion that communicates with lumbar intervertebral discs. Surgical resection of the cyst is the reported treatment of choice. In this study, the authors report the minimally invasive surgical resection of lumbar discal cysts using a microendoscopy.

Patients and Methods: Seven male patients with lumbar discal cysts underwent microendoscopic resections (mean age: 25.1±3.2 years and the mean follow-up period: 27.9 months). During the surgeries, the cysts were subtotally resected in a piecemeal fashion, and the fistulas forming the communications between the cysts and the corresponding intervertebral discs were coagulated using a bipolar coagulator.

Results: All the patients obtained relief from their pain after surgery, and no recurrences occurred during a mean follow-up period of 28 months. The mean operation time was 72.6±20.2 min, and the mean blood loss was 44.4±13.7 grams. No intra- or peri-operative complications were noted in any of the patients.

Conclusions: Microendoscopic resection appears to be a minimally invasive and feasible surgical option for the treatment of lumbar discal cysts.

microendoscopic discectomy - discal cyst - surgery - lumbar spine

References

• 1 Chiba K, Toyama Y, Matsumoto M. et al . Intraspinal cyst communicating with the intervertebral disc in the lumbar spine: discal cyst.  Spine. 2001;  26 2112-2118
• 2 Coscia MF, Broshears JR. Lumbar spine intracanalicular discal cysts: two case reports.  J Spinal Disord Tech. 2002;  15 431-435
• 3 Jeong GK, Bendo JA. Lumbar intervertebral disc cyst as a cause of radiculopathy.  Spine J. 2003;  3 242-246
• 4 Marshman LA, Benjamin JC, David KM. et al . “Disc cysts” and “posterior longitudinal ligament ganglion cysts”: synonymous entities? Report of three cases and literature review.  Neurosurgery. 2005;  57 E818
• 5 Nabeta M, Yoshimoto H, Sato S. et al . Discal cysts of the lumbar spine. Report of five cases.  J Neurosurg Spine. 2007;  6 85-89
• 6 Ishii K, Matsumoto M, Watanabe K. et al . Endoscopic resection of cystic lesions in the lumbar spinal canal: a report of two cases.  Minim Invas Neurosurg. 2005;  48 240-243
• 7 Foley KT, Smith MM. Microendoscopic Discectomy. Techniques in Neurosurgery. Vol 3, No 4, pp 301-307 Lippincott- Raven Publishers, Philadelphia; 1997
• 8 Huang TJ, Hsu RW, Li YY. et al . Less systemic cytokine response in patients following microendoscopic versus open lumbar discectomy.  J Orthop Res. 2005;  23 406-411
• 9 Wu X, Zhuang S, Mao Z. et al . Microendoscopic discectomy for lumbar disc herniation: surgical technique and outcome in 873 consecutive cases.  Spine. 2006;  31 2689-2694
• 10 Ikuta K, Arima J, Tanaka T. et al . Short-term results of microendoscopic posterior decompression for lumbar spinal stenosis. Technical note.  J Neurosurg Spine. 2005;  2 624-633
• 11 Matsumoto M, Chiba K, Ishii K. et al . Microendoscopic partial resection of the sacral ala to relieve extraforaminal entrapment of the L-5 spinal nerve at the lumbosacral tunnel. Technical note.  J Neurosurg Spine. 2006;  4 342-346
• 12 Izumida S, Inoue S. Assessment of treatment for low back pain [in Japanese].  J Jpn Orthop Assoc. 1986;  60 391-394
• 13 Kono K, Nakamura H, Inoue Y. et al . Intraspinal extradural cysts communicating with adjacent herniated disks: imaging characteristics and possible pathogenesis.  Am J Neuroradiol. 1999;  20 1373-1377
• 14 Lee HK, Lee DH, Choi CG. et al . Discal cyst of the lumbar spine: MR imaging features.  Clin Imaging. 2006;  30 326-330
• 15 Koga H, Yone K, Yamamoto T. et al . Percutaneous CT-guided puncture and steroid injection for the treatment of lumbar discal cyst: a case report.  Spine. 2003;  28 E212-E216
• 16 Freeman BJ, Walters RM, Moore RJ. et al . Does intradiscal electrothermal therapy denervate and repair experimentally induced posterolateral annular tears in an animal model?.  Spine. 2003;  28 2602-2608

Correspondence