Clinical Outcomes of Percutaneous Endoscopic Surgery for Lumbar Discal Cyst

Journal of Korean Neurosurgical Society 2012³â 51±Ç 4È£ p.208 ~ p.214

ÇÏ»ó¿ì(Ha Sang-Woo) - Á¶¼±´ëÇб³ ÀÇ°ú´ëÇÐ ½Å°æ¿Ü°úÇб³½Ç
ÁÖâÀÏ(Ju Chang-Il) - Á¶¼±´ëÇб³ ÀÇ°ú´ëÇÐ ½Å°æ¿Ü°úÇб³½Ç
±è¼®¿ø(Kim Seok-Won) - Á¶¼±´ëÇб³ ÀÇ°ú´ëÇÐ ½Å°æ¿Ü°úÇб³½Ç
À̽¸í(Lee Seung-Myung) - Á¶¼±´ëÇб³ ÀÇ°ú´ëÇÐ ½Å°æ¿Ü°úÇб³½Ç
±è¿ëÇö(Kim Yong-Hyun) - Ã·´ÜÁ¾ÇÕº´¿ø ½Å°æ¿Ü°ú
±èÇö¼º(Kim Hyeun-Sung) - Ç㸮»ç¶ûº´¿ø ½Å°æ¿Ü°ú

Abstract

Objective: Discal cyst is rare and causes indistinguishable symptoms from lumbar disc herniation. The clinical manifestations and pathological features of discal cyst have not yet been completely known. Discal cyst has been treated with surgery or with direct intervention such as computed tomography (CT) guided aspiration and steroid injection. The purpose of this study is to evaluate the safety and efficacy of the percutaneous endoscopic surgery for lumbar discal cyst over at least 6 months follow-up.

Methods: All 8 cases of discal cyst with radiculopathy were treated by percutaneous endoscopic surgery by transforaminal approach. The involved levels include L5-S1 in 1 patient, L3-4 in 2, and L4-5 in 5. The preoperative magnetic resonance imaging and 3-dimensional CT with discogram images in all cases showed a connection between the cyst and the involved intervertebral disc. Over a 6-months period, self-reported measures were assessed using an outcome questionaire that incorporated total back-related medical resource utilization and improvement of leg pain [visual analogue scale (VAS) and Macnab¡¯s criteria].

Results: All 8 patients underwent endoscopic excision of the cyst with additional partial discectomy. Seven patients obtained immediate relief of symptoms after removal of the cyst by endoscopic approach. There were no recurrent lesions during follow-up period. The mean preoperative VAS for leg pain was 8.25¡¾0.5. At the last examination followed longer than 6 month, the mean VAS for leg pain was 2.25¡¾2.21. According to MacNab¡¯ criteria, 4 patients (50%) had excellent results, 3 patients (37.5%) had good results; thus, satisfactory results were achieved in 7 patients (87.5%). However, one case had unsatisfactory result with persistent leg pain and another paresthesia.

Conclusion: The radicular symptoms were remarkably improved in most patients immediately after percutaneous endoscopic cystectomy by transforaminal approach.

Å°¿öµå

Lumbar discal cyst, Percutaneous endoscopic transforaminal cystectomy
¿ø¹® ¹× ¸µÅ©¾Æ¿ô Á¤º¸
µîÀçÀú³Î Á¤º¸
SCI(E) ÇмúÁøÈïÀç´Ü(KCI) KoreaMed ´ëÇÑÀÇÇÐȸ ȸ¿ø 
ÁÖÁ¦ÄÚµå
ÁÖÁ¦¸í(Target field)
¿¬±¸´ë»ó(Population)
¿¬±¸Âü¿©(Sample size)
´ë»ó¼ºº°(Gender)
Áúº´Æ¯¼º(Condition Category)
¿¬±¸È¯°æ(Setting)
¿¬±¸¼³°è(Study Design)
¿¬±¸±â°£(Period)
ÁßÀç¹æ¹ý(Intervention Type)
ÁßÀç¸íĪ(Intervention Name)
Å°¿öµå(Keyword)
À¯È¿¼º°á°ú(Recomendation)
Seven patients obtained immediate relief of symptoms after removal of the cyst by endoscopic approach.
¿¬±¸ºñÁö¿ø(Fund Source)
±Ù°Å¼öÁØÆò°¡(Evidence Hierarchy)
ÃâÆdz⵵(Year)
Âü¿©ÀúÀÚ¼ö(Authors)
´ëÇ¥ÀúÀÚ
DOI
KCDÄÚµå
ICD 03
°Ç°­º¸ÇèÄÚµå