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Spine (Phila Pa 1976). 2002 Jun 1;27(11):E278-80.

An unusual presentation of a lumbar synovial cyst: case report.

Author information

1
Department of Neurosurgery and Neuropathology, Hopital Timone, Marseille, France. p.metellus@infonie.fr

Abstract

STUDY DESIGN:

A case of intraforaminal synovial cyst is reported.

OBJECTIVES:

To stress the importance of the way intraforaminal synovial cyst, a very rare condition, causes a peculiar position of the nerve root in the foramen and to describe the required surgical approach.

SUMMARY OF BACKGROUND DATA:

Intraforaminal synovial cyst is a highly unusual finding. The existence of this rare entity raises the problem of differential diagnosis with other space-occupying lesions of the neural foramen, such as herniated disc, neurinoma, neurofibroma, and metastatic lesions

METHODS AND RESULTS:

A 64-year-old woman suffered a right L4 radiculopathy with motor deficit. Computed tomography showed a space-occupying lesion in the L4-L5 foramen isodense with the disc. Magnetic resonance images showed a right intraforaminal cystic lesion at the L4-L5 level with no enhancement after intravenous infusion of gadolinium. A 3-cm cystic lesion, which appeared to arise from the L4-L5 facet joint without direct communication, was excised from the L4-L5 foramen. In contrast with intraforaminal disc herniation, downward displacement of the L4 nerve root was observed. Two months after surgery, the patient was pain-free and neurologic examination revealed no motor deficit.

CONCLUSIONS:

An unusual intraforaminal presentation of a lumbar synovial cyst demonstrates the importance of considering this entity and of adapting the surgical technique to avoid injury to the nerve root.

PMID:
12045529
[Indexed for MEDLINE]
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