Steroid Injection Performed with Fluoroscopy for Treatment of a Discal Cyst
Steroid Injection Performed with Fluoroscopy for Treatment of a Discal Cyst
复制标题
DOI：
10.3899/jrheum.090050
复制
发表时间：
2009-08
期刊：
影响因子：
--
通讯作者：
T. Dumay-Levesque;A. Souteyrand;J. Michel
中科院分区：
文献类型：
--
作者：
T. Dumay-Levesque;A. Souteyrand;J. Michel
致编辑：与椎间盘相通的椎管内硬膜外囊肿是一种罕见的实体，因此是腰椎神经根病的罕见原因。腰椎椎管内囊肿有几种不同发病机制的类型，如神经周围囊肿、滑膜囊肿1,2、蛛网膜囊肿3、硬膜外血肿4、黄韧带囊肿5、神经节囊肿6、椎管内积气7和椎间盘囊肿8。我们描述了通过 X 线摄影引导下类固醇注射治疗的椎间盘囊肿。一名 35 岁的男子出现腰痛，并在一年内逐渐恶化。疼痛变得呈根性，并向下辐射到左腿外侧直至膝盖上方。神经学检查显示所有皮节模式的感觉完整，双侧深腱反射正常。腰骶椎的平片显示有最小的退行性改变，但没有脊柱节段不稳定、畸形或脊椎病的迹象。磁共振成像（MRI）显示硬膜外球形肿物7 × 8 × 10 mm，位于L3椎体后方椎管左腹外侧硬膜外间隙（图1至4），延伸至L4侧隐窝，T1加权成像低信号，T2加权成像稍高信号，对比后边缘增强 注射。囊肿使硬脑膜囊向背侧移位。囊肿附近的 L3-L4 盘和……向 Dumay-Levesque 博士提出重印请求；电子邮件：tiphdumay{at}yahoo.fr
To the Editor: Intraspinal extradural cysts that communicate with the intervertebral disk are a rare entity and thus an uncommon cause of lumbar radiculopathy. Several types of lumbar intraspinal cysts with different pathogenesis have been reported, such as perineural cysts, synovial cysts1,2, arachnoid cysts3, epidural hematoma4, cyst of the ligamentum flavum5, ganglion cysts6, intraspinal gas7, and discal cysts8. We describe a discal cyst treated by roentgenography-guided steroid injection. A 35-year-old man presented with lower back pain that gradually worsened over the course of a year. The pain became radicular, and radiated down the lateral portion of his left leg to just above the knee. The neurological examination demonstrated intact sensation along all dermatomal patterns and normal deep tendon reflexes bilaterally. Plain radiographs of the lumbosacral spine revealed minimal degenerative changes, but no signs of spinal segmental instability, deformity, or spondylosis. Magnetic resonance imaging (MRI) revealed an extradural spherical mass 7 × 8 × 10 mm seated in the left ventrolateral epidural space of the spinal canal behind the L3 vertebral body (Figures 1 to 4) that extended into the lateral recess of L4, with low signal intensity on T1-weighted imaging, slight high signal intensity on T2-weighted imaging, and rim enhancement after contrast injection. The cyst displaced the dural sac dorsally. The L3-L4 disk adjacent to the cyst and the … Address reprint requests to Dr. Dumay-Levesque; E-mail: tiphdumay{at}yahoo.fr