J Korean Neurosurg Soc.  2013 Apr;53(4):255-257. 10.3340/jkns.2013.53.4.255.

Intraoperative Discography for Detecting Concealed Lumbar Discal Cysts

Affiliations
  • 1Department of Neurosurgery, Daegu Wooridul Spine Hospital, Daegu, Korea.
  • 2Department of Neurosurgery, Chungdam Wooridul Spine Hospital, Seoul, Korea. chul5104@hanmail.net
  • 3Department of Neurosurgery, Seoul Wooridul Spine Hospital, Seoul, Korea.

Abstract

Lumbar discal cyst is a rare cause of radiculopathy. Their exact pathogenesis and the optimal treatment modality remain unidentified. Depending on their location, discal cysts cannot always be easily identified intraoperatively. We describe 2 patients with discal cysts and introduce an intraoperative discography technique for discal cyst location. Both patients were treated with surgical excision; with intraoperative discography, the cystic lesions could easily be detected and removed.

Keyword

Discal cyst; Intraoperative discography

MeSH Terms

Humans
Radiculopathy

Figure

  • Fig. 1 A : Preoperative sagittal T2-weighted magnetic resonance imaging (MRI) showing a cystic lesion with high signal intensity at the L3-4 level. B : Preoperative axial T2-weighted MRI showing a cystic lesion with high signal intensity at the L3-4 level. C : First postoperative axial T2-weighted MRI showing the remaining cystic lesion. D : Second postoperative axial T2-weighted MRI showing that the cystic lesion has been completely removed.

  • Fig. 2 A : Intraoperative discography showing contrast filling a cystic lesion. B : Intraoperative discography, after discal cyst removal, showing no further contrast filling.

  • Fig. 3 A : Preoperative sagittal T2-weighted MRI showing a cystic lesion with high intensity. B : Preoperative axial T2-weighted MRI showing a cystic lesion with high intensity. C : The cyst is lined with fibrous connective tissue without an epithelial-cell layer (hematoxylin and eosin).


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