11/41. cysts of the atlantoaxial joint: excellent long-term outcome after posterolateral surgical decompression. Report of two cases.Articular cysts of the atlantoaxial joint are infrequently described and probably an underreported cause of upper cervical spinal cord compression. The authors report on two patients with cysts located posteriorly of the dens in whom a C-1 and partial C-2 hemilaminectomy with subtotal resection of the cyst provided adequate and stable decompression 1 year postoperatively. The clinical and magnetic resonance imaging features and the surgical approach are discussed after a review of the literature.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
12/41. Lumbar spine synovial cysts. A case report and review of the literature.This paper reports the case of a sixty-year-old man who presented with backache and radiculopathy secondary to the development of a lumbar spinal synovial cyst following an episode of trauma. There was resection of the cyst with partial facetectomy. Current literature reports are outlined.- - - - - - - - - - ranking = 22.19657160881keywords = back (Clic here for more details about this article) |
13/41. association of spondylarthropathies with lumbar synovial cysts.Intraspinal synovial cysts presenting with lower back pain and radiculopathy are well known but rare. They are associated with facet joint arthopathy, generally degenerative in nature. Spinal synovial cysts have not been described in spondyloarthropathies (SpA). We report a case of a 66-year-old man with a chronic undifferentiated SpA who presented with severe weakness of both legs. A centrally located spinal cyst was encountered on MRI and led to excision of a highly inflammatory synovial cyst. This association may not be fortuitous and be related to inflammation of the facet joint in SpA.- - - - - - - - - - ranking = 309.30176099957keywords = back pain, back (Clic here for more details about this article) |
14/41. Intramuscular ganglion arising from the acromioclavicular joint.We report a case of a 80-year-old White woman presenting with a localized painless swelling in the upper parascapular region of the right shoulder. Ultrasound (US) showed a ganglion arising from the acromioclavicular joint (ACJ) and extending inside the trapezius muscle, together with a massive tear of the rotator cuff (RC). magnetic resonance imaging (MRI) confirmed the US findings. ganglia arising from the ACJ are rare and usually associated with massive RC tears. Their intramuscular extension, to the best of our knowledge, has never been reported in the radiological literature and can mimic a tumor.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
15/41. synovial cyst at the C1-C2 junction in a patient with atlantoaxial subluxation.Synovial cysts of the cervical spine causing myelopathy are rare. The pathogenesis of these cysts is often attributed to degenerative changes of the facet joints or microtrauma. The authors report a synovial cyst at the C1-C2 junction in a patient with atlantoaxial subluxation without a congenital anomaly or inflammatory conditions. A 72-year-old man presented with a progressive right-sided myelopathy attributed to a C1-C2 synovial cyst accompanied by atlantoaxial subluxation and C3-C6 spondylosis. magnetic resonance imaging of the cervical spine showed a large cystic mass compressing the spinal cord located at the C1-C2 junction. A C1 hemilaminectomy, complete evacuation of the cyst contents, and posterior atlantoaxial fusion were performed, and a double-door laminoplasty was also done at C3-C6. The patient showed significant improvement of paresthesia and motor weakness of the right upper and lower extremities immediately after the operation. Synovial cysts should be considered in the differential diagnosis of an extradural mass of the upper cervical spine. Posterior fusion combined with direct excision of the cyst may be the optimum treatment of a synovial cyst at the C1-C2 junction in a patient with atlantoaxial subluxation.- - - - - - - - - - ranking = 2keywords = upper (Clic here for more details about this article) |
16/41. Lumbar synovial cyst as a cause of low back pain and acute radiculopathy: a case report.The authors report the case of a 69-year old female with a persistent history of low back pain. Plain lumbar radiographs, performed at symptom initiation, revealed lumbar spondylolisthesis. low back pain was attributed to this, and the patient received conservative treatment with partial relief of symptoms. Four years later, and as a result of acute onset of radicular symptoms, a lumbar spine magnetic resonance imaging scan was performed, revealing an epidural cystic lesion. The cyst was removed, and histopathology revealed a synovial cyst.- - - - - - - - - - ranking = 1855.8105659974keywords = back pain, back (Clic here for more details about this article) |
17/41. chiropractic treatment of lumbar spine synovial cysts: a report of two cases.OBJECTIVE: To present the treatment of low back and radicular pain due to synovial cysts of the lumbar spine including chiropractic distraction manipulation and physiological therapeutic care. CLINICAL FEATURES: Two patients (71-year-old man and 59-year-old woman) with magnetic resonance imaging (MRI)-diagnosed large synovial cysts at the L3 through L4 and L4 through L5 vertebral levels, respectively, had lower extremity pain, numbness, and tingling of the respective L4 and L5 dermatomes. INTERVENTION AND OUTCOME: chiropractic distraction manipulation was performed at the level of the synovial cyst. The manipulation was performed daily until 50% pain relief was attained, followed by diminished frequency of care. Physiotherapy included positive galvanism, iontophoresis, tetanizing electrical stimulation, stabilization exercises, and home cryotherapy. The male patient's pain was reduced by 50% in 14 days and 100% at 60 days. Range of motion of the thoracolumbar spine increased, walking distance increased from 1 to 2 blocks to 1 mile without pain, and repeat MRI showed reduced size of the cyst. The female patient, under the same treatment regimen, was pain free in 6 weeks. CONCLUSION: chiropractic distraction manipulation and physiological therapeutic care relieved 2 patients with low back and radicular pain attributed to MRI-confirmed synovial cysts of the lumbar spine. This treatment may be an initial conservative treatment option for synovial cysts with careful patient monitoring for progressive neurologic deficit which would necessitate surgery. Distraction manipulation may be a safe and effective conservative treatment of synovial cyst causing radicular pain; further data collection of clinical outcomes is warranted.- - - - - - - - - - ranking = 44.393143217621keywords = back (Clic here for more details about this article) |
18/41. Symptomatic epidural hematoma caused by lumbar synovial cyst rupture: report of two cases and review of the literature.OBJECTIVE AND IMPORTANCE: Juxtafacet cysts of the lumbar spine are a recognized cause of back pain, radicular symptoms, neurogenic claudication, and, less often, cauda equina compression syndrome. Hemorrhagic rupture of a juxtafacet cyst and the resulting epidural hematoma may cause chronic and/or acute cauda equina compression. CLINICAL PRESENTATION: We report two cases of ruptured hemorrhagic lumbar synovial cysts resulting in epidural hematoma and progressive symptomatic cauda equina compression. INTERVENTION: Surgical excision of the epidural hematoma and the associated cyst resulted in complete resolution of symptoms. CONCLUSION: Rarely, juxtafacet cysts of the lumbar spine may rupture and hemorrhage into the epidural space causing symptomatic cauda equina compression. It is important to consider this entity when evaluating the patient with cauda equina compression. The findings of these cases give insight into the clinical presentation, operative treatment, and outcome in these patients.- - - - - - - - - - ranking = 309.30176099957keywords = back pain, back (Clic here for more details about this article) |
19/41. Hemorrhagic lumbar synovial facet cyst secondary to anticoagulation therapy.BACKGROUND CONTEXT: Acute onset of radicular symptoms has been reported following hemorrhage into lumbar synovial cysts after trauma or in cases of spinal instability. No previous cases have been linked to anticoagulation therapy. PURPOSE: To present a case of symptomatic hemorrhagic lumbar synovial cyst occurring after anticoagulation therapy. STUDY DESIGN: A case report and review of the literature. methods: A patient presented with low back and radicular pain secondary to a large synovial facet cyst. magnetic resonance imaging revealed a large facet cyst compressing the thecal sac and L3 exiting nerve root. RESULTS: The synovial cyst was excised during a lumbar decompression and fusion. Gross blood was present in the cyst. CONCLUSIONS: This is the first reported case of symptomatic hemorrhagic lumbar facet cyst associated with anticoagulation therapy.- - - - - - - - - - ranking = 22.19657160881keywords = back (Clic here for more details about this article) |
20/41. Suprascapular intraneural ganglia and glenohumeral joint connections.OBJECT: Unlike the more commonly noted paralabral cysts (extraneural ganglia), which are well known to result in suprascapular nerve compression, only four cases of suprascapular intraneural ganglia have been reported. Because of their rarity, the pathogenesis of suprascapular intraneural ganglia has been poorly understood and a pathoanatomical explanation has not been provided. In view of the growing literature demonstrating strong associations between paralabral cysts and labral (capsular) pathology, joint connections, and joint communications, the authors retrospectively reviewed the magnetic resonance (MR) imaging studies and postoperative results in the two featured patients to test a hypothesis that suprascapular intraneural ganglia would have analogous findings. methods: Two patients who presented with suprascapular neuropathy were found to have intraneural ganglia. Connections to the glenohumeral joint could be established in both patients through posterior labrocapsular complex tears. In neither patient was the joint connection identified preoperatively or intraoperatively, and cyst decompression was performed by itself without attention to the labral tear. The suprascapular intraneural ganglia extended from the glenohumeral joint as far proximally as the level of the nerves' origin from the upper trunk in the supraclavicular fossa. Although both patients experienced symptomatic improvement after surgery, neurological recovery was incomplete. In both cases, postoperative MR images revealed cyst persistence. In addition, previously unrecognized superior labral anteroposterior (SLAP) Type II lesions (tears of the superior labrum extending anteroposterior and involving the biceps anchor at the labrum without actual extension into the tendon) were visualized. In one patient with a persistent cyst, an MR arthrogram was obtained and demonstrated a communication between the joint and the cyst. CONCLUSIONS: The findings in these two patients support the synovial theory for intraneural ganglia. Based on their experience with intraneural ganglia at other sites, the authors believe that suprascapular intraneural ganglia arise from the glenohumeral joint, egress through a superior (posterior) labral tear, and dissect within the epineurium along an articular branch into the main nerve, following the path of least resistance. Furthermore, these two cases of intraneural ganglia with SLAP lesions are directly analogous to the many cases of paralabral cysts associated with these types of labral tears. By better understanding the origin of this unusual type of ganglia and drawing analogies to the more common extraneural cysts, surgical strategies can be formulated to address the underlying pathoanatomy, improve operative outcomes, and prevent recurrences.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
| <- Previous || Next -> |