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Percutaneous Endoscopic Discectomy via Transforaminal Route for Discal Cyst.

Jha SC, Higashino K, Sakai T, Takata Y, Abe M, Nagamachi A, Fukuta S, Sairyo K - Case Rep Orthop (2015)

Bottom Line: Results.Conclusion.A minimal invasive procedure like PED can be an effective surgical treatment for discal cyst, especially in active individuals who play sports.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Tokushima University, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.

ABSTRACT
Background. Discal cyst has been identified as a rare cause of low back pain and radiating leg pain. The pathogenesis and management of this condition are still debated. The largest number of reported cases had undergone microsurgery while very few cases have been treated with percutaneous endoscopic discectomy (PED). Methods. An 18-year-old boy complained of low back pain radiating to right leg after a minor road traffic accident. Diagnosis of a discal cyst at L4-L5 level was made based on magnetic resonance imaging (MRI). Despite conservative management for 6 months, the low back pain and radiating leg pain persisted so surgical treatment by PED was performed under local anesthesia. As the patient was a very active baseball player, his physician recommended a minimally invasive procedure to avoid damage to the back muscles. Results. The patient's low back pain and leg pain disappeared immediately after surgery and he made a rapid recovery. He resumed mild exercise and sports practice 4 weeks after surgery. Complete regression of the cystic lesion was demonstrated on the 2-month postoperative MRI. Conclusion. A minimal invasive procedure like PED can be an effective surgical treatment for discal cyst, especially in active individuals who play sports.

No MeSH data available.


Related in: MedlinePlus

(a) Clinical appearance of the surgical scar after the procedure. (b) Confirmation of the residual cystic mass at the ventral epidural space by a probe.
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fig3: (a) Clinical appearance of the surgical scar after the procedure. (b) Confirmation of the residual cystic mass at the ventral epidural space by a probe.

Mentions: Next, discography was conducted and indigo carmine was used to dye the nucleus pulposus blue, helping to identify the herniated fragment. A guide pin was inserted into the disc through the puncture needle, and the obturator and cannula were inserted sequentially through the 8-mm skin incision (Figure 3(a)). The patient's leg pain disappeared after insertion of the 8-mm cannula. This might have indicated shrinkage of the discal cyst after disruption of the cyst wall.


Percutaneous Endoscopic Discectomy via Transforaminal Route for Discal Cyst.

Jha SC, Higashino K, Sakai T, Takata Y, Abe M, Nagamachi A, Fukuta S, Sairyo K - Case Rep Orthop (2015)

(a) Clinical appearance of the surgical scar after the procedure. (b) Confirmation of the residual cystic mass at the ventral epidural space by a probe.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556867&req=5

fig3: (a) Clinical appearance of the surgical scar after the procedure. (b) Confirmation of the residual cystic mass at the ventral epidural space by a probe.
Mentions: Next, discography was conducted and indigo carmine was used to dye the nucleus pulposus blue, helping to identify the herniated fragment. A guide pin was inserted into the disc through the puncture needle, and the obturator and cannula were inserted sequentially through the 8-mm skin incision (Figure 3(a)). The patient's leg pain disappeared after insertion of the 8-mm cannula. This might have indicated shrinkage of the discal cyst after disruption of the cyst wall.

Bottom Line: Results.Conclusion.A minimal invasive procedure like PED can be an effective surgical treatment for discal cyst, especially in active individuals who play sports.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedics, Tokushima University, 3-18-15 Kuramoto, Tokushima 770-8503, Japan.

ABSTRACT
Background. Discal cyst has been identified as a rare cause of low back pain and radiating leg pain. The pathogenesis and management of this condition are still debated. The largest number of reported cases had undergone microsurgery while very few cases have been treated with percutaneous endoscopic discectomy (PED). Methods. An 18-year-old boy complained of low back pain radiating to right leg after a minor road traffic accident. Diagnosis of a discal cyst at L4-L5 level was made based on magnetic resonance imaging (MRI). Despite conservative management for 6 months, the low back pain and radiating leg pain persisted so surgical treatment by PED was performed under local anesthesia. As the patient was a very active baseball player, his physician recommended a minimally invasive procedure to avoid damage to the back muscles. Results. The patient's low back pain and leg pain disappeared immediately after surgery and he made a rapid recovery. He resumed mild exercise and sports practice 4 weeks after surgery. Complete regression of the cystic lesion was demonstrated on the 2-month postoperative MRI. Conclusion. A minimal invasive procedure like PED can be an effective surgical treatment for discal cyst, especially in active individuals who play sports.

No MeSH data available.


Related in: MedlinePlus