A Growing Pre-existing Juxta-facet Cyst after Lumbar Laminectomy: Report of a Case

先前已存在近關節面之囊腫，於腰椎椎板切除後變大之個案極爲少見。我們報告一位胡歲婦人，因第四、五腰椎狹窄及椎問盤突出，接受腰椎椎板切除手術後一個月，發生急性臀部及復發性第五腰椎神經痛。磁振造影顯示一囊腫由關節面延伸至神經管，壓迫到左側第五腰椎神經根。病人接受止痛藥物、臥床休息及合身束腹帶治療，未經外科手術，症狀即見緩解。六個月後，磁振造影追蹤發現此囊腫已縮小，對第五腰椎神經管及神經根不再壓迫。病理產生原因可能與腰椎椎板切除後及退化性關節過度活動有關。此案例顯示：於腰椎椎板切除後，若發生復發性神經根疼痛，病因可能是先前已存在近關節面之囊腫，於腰椎椎板切除後變大。其次，可考慮先接受保守療法，因爲囊腫自發性消退是可能的。

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並列摘要

The growth of a pre-existing lumbar juxta-facet cyst after a laminectomy is a rare condition. Here we report a 60-year-old woman who presented with acute severe buttock pain and recurrent left L5 radicular pain one month after a laminectomy for L4-5 spinal stenosis and a herniated intervertebral disc. Magnetic resonance imaging (MRI) revealed that a cyst extending from the facet joint to the spinal canal compressed the left L5 nerve root. Without surgical intervention, the patient's condition improved after analgesic medication, bed rest and the fitting of a lumbar corset. At the 6-month follow-up, the MRI showed spontaneous resolution of the cyst with no narrowing of the spinal canal or root compression. The pathogenesis of the cyst could have been related to the degenerative mobile spine after the decompressive laminectomy. This case demonstrates that post-laminectomy recurrence of radiculopathy may result from the growth of a pre-existing juxta-facet cyst. Furthermore, conservative treatment may be the first therapeutic option because spontaneous resolution of such a cyst is known to be possible.

並列關鍵字

juxta-facet cyst ； post-laminectomy ； radiculopathy

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A Growing Pre-existing Juxta-facet Cyst after Lumbar Laminectomy: Report of a Case

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