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A pure fluid-filled intradural cyst associated with intradural disc herniation and possible pathogenesis: a case report.
Spine J. 2013 Nov; 13(11):e11-5.SJ

Abstract

BACKGROUND CONTEXT

Lumbar intradural disc herniation (IDH) is rare, and intradural cyst associated with IDH is quite rare. Only seven cases of an intradural cyst associated with lumbar disc herniation have been reported, and all were gas-filled cysts. We report the first case, to our knowledge, of a fluid-filled intradural cyst associated with IDH.

PURPOSE

To report an extremely rare case of a fluid-filled intradural cyst associated with lumbar IDH and suggests the possible pathogenesis.

STUDY DESIGN

Case report.

METHODS

An 82-year-old woman presented with right leg pain and motor weakness. Computed tomography and magnetic resonance imaging (MRI) scans showed calcified lumbar disc herniation and an intradural cystic mass at the L1-L2 level. An MRI, which was performed 2 years before admission, showed an IDH without a cyst at the same level.

RESULTS

Surgical resection of the intradural cyst was performed. Intraoperative finding showed a fluid-filled intradural cyst with 1-cm diameter of displacing nerve rootlets. The cyst was connected with extradural cystic components through a ventral dural hole, but the tract was blocked by fibrous septum. Histopathologic examination showed a pseudocyst that consisted of degenerative cartilaginous and fibrous tissues, including degenerative disc materials. We concluded that the cyst was an intradural cyst transformed from the intradural disc fragment.

CONCLUSIONS

The current case is the first report to our knowlege of a fluid-filled intradural cyst associated with IDH. The possible mechanism may be focal degeneration and spontaneous absorption of the intradural disc with fluid production. Unlike the gas-filled intradural cysts, the cause of the pure fluid-filled cyst may be disconnection from the intervertebral vacuum because of a calcified disc and septation of the cyst.

Authors+Show Affiliations

Department of Neurosurgery & Medical Research Institute, Pusan National University Hospital, Pusan National University School of Medicine, 305 Gudeok-Ro Seo-Gu, Busan 602-739, Korea.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

23932776

Citation

Nam, Kyoung Hyup, et al. "A Pure Fluid-filled Intradural Cyst Associated With Intradural Disc Herniation and Possible Pathogenesis: a Case Report." The Spine Journal : Official Journal of the North American Spine Society, vol. 13, no. 11, 2013, pp. e11-5.
Nam KH, Han IH, Cho WH, et al. A pure fluid-filled intradural cyst associated with intradural disc herniation and possible pathogenesis: a case report. Spine J. 2013;13(11):e11-5.
Nam, K. H., Han, I. H., Cho, W. H., & Choi, B. K. (2013). A pure fluid-filled intradural cyst associated with intradural disc herniation and possible pathogenesis: a case report. The Spine Journal : Official Journal of the North American Spine Society, 13(11), e11-5. https://doi.org/10.1016/j.spinee.2013.06.009
Nam KH, et al. A Pure Fluid-filled Intradural Cyst Associated With Intradural Disc Herniation and Possible Pathogenesis: a Case Report. Spine J. 2013;13(11):e11-5. PubMed PMID: 23932776.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A pure fluid-filled intradural cyst associated with intradural disc herniation and possible pathogenesis: a case report. AU - Nam,Kyoung Hyup, AU - Han,In Ho, AU - Cho,Won Ho, AU - Choi,Byung Kwan, Y1 - 2013/08/08/ PY - 2012/07/02/received PY - 2013/03/19/revised PY - 2013/06/01/accepted PY - 2013/8/13/entrez PY - 2013/8/13/pubmed PY - 2014/8/12/medline KW - Fluid-filled cyst KW - Gas-filled cyst KW - Intradural disc herniation KW - Lumbar spine SP - e11 EP - 5 JF - The spine journal : official journal of the North American Spine Society JO - Spine J VL - 13 IS - 11 N2 - BACKGROUND CONTEXT: Lumbar intradural disc herniation (IDH) is rare, and intradural cyst associated with IDH is quite rare. Only seven cases of an intradural cyst associated with lumbar disc herniation have been reported, and all were gas-filled cysts. We report the first case, to our knowledge, of a fluid-filled intradural cyst associated with IDH. PURPOSE: To report an extremely rare case of a fluid-filled intradural cyst associated with lumbar IDH and suggests the possible pathogenesis. STUDY DESIGN: Case report. METHODS: An 82-year-old woman presented with right leg pain and motor weakness. Computed tomography and magnetic resonance imaging (MRI) scans showed calcified lumbar disc herniation and an intradural cystic mass at the L1-L2 level. An MRI, which was performed 2 years before admission, showed an IDH without a cyst at the same level. RESULTS: Surgical resection of the intradural cyst was performed. Intraoperative finding showed a fluid-filled intradural cyst with 1-cm diameter of displacing nerve rootlets. The cyst was connected with extradural cystic components through a ventral dural hole, but the tract was blocked by fibrous septum. Histopathologic examination showed a pseudocyst that consisted of degenerative cartilaginous and fibrous tissues, including degenerative disc materials. We concluded that the cyst was an intradural cyst transformed from the intradural disc fragment. CONCLUSIONS: The current case is the first report to our knowlege of a fluid-filled intradural cyst associated with IDH. The possible mechanism may be focal degeneration and spontaneous absorption of the intradural disc with fluid production. Unlike the gas-filled intradural cysts, the cause of the pure fluid-filled cyst may be disconnection from the intervertebral vacuum because of a calcified disc and septation of the cyst. SN - 1878-1632 UR - https://www.unboundmedicine.com/medline/citation/23932776/A_pure_fluid_filled_intradural_cyst_associated_with_intradural_disc_herniation_and_possible_pathogenesis:_a_case_report_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1529-9430(13)00684-0 DB - PRIME DP - Unbound Medicine ER -