ABSTRACT
A rare case of ligamentum flavum cyst of the lumbar spine in an elderly male is reported. The patient presented with low backache and features of bilateral radiculopathy of a sudden onset. The cyst was lying in the extradural space. After surgery, the patient reported complete relief of symptoms.
ABSTRACT
OBJECTIVE: To describe a novel spinous process-splitting hemilaminoplasty technique for the surgical treatment of intradural and posterior epidural lesions that promotes physiological restoration. METHODS: The spinous process was split, the area of the facet lamina junction was drilled, and en bloc hemilaminectomy was then performed. After removing intradural and posterior epidural lesions, we fitted the previously en bloc-removed bone to the pre-surgery same shape, and held it in place with non-absorbable sutures. Surgery was performed on 16 laminas from a total of nine patients between 2011 and 2014. Bony union of the reconstructed lamina was assessed using computed tomography (CT) at 6 months after surgery. RESULTS: Spinous process-slitting hemilaminoplasty was performed for intradural extramedullary tumors in eight patients and for ossification of the ligament flavum in one patient. Because we were able to visualize the margin of the ipsilateral and contralateral dura, we were able to secure space for removal of the lesion and closure of the dura. None of the cases showed spinal deformity or other complications. Bone fusion and maintenance of the spinal canal were found to be perfect on CT scans. CONCLUSION: The spinous process-splitting hemilaminoplasty technique presented here was successful in creating sufficient space to remove intradural and posterior epidural lesions and to close the dura. Furthermore, we were able to maintain the physiological barrier and integrity after surgery because the posterior musculature and bone structures were restored.
Subject(s)
Humans , Congenital Abnormalities , Ligaments , Spinal Canal , Sutures , Tomography, X-Ray ComputedABSTRACT
Se presenta el caso clínico de un paciente de 57 años de edad, de la raza blanca, con cuadro clínico de compresión medular dorsal, por lo cual se le realizó una laminectomía de D5-D7, con resección de una lesión extradural, de color vino, redondeada, de 3x2x2 cm. Los resultados de la biopsia confirmaron el diagnóstico de una malformación angiomatosa (cavernoma). La cirugía es el tratamiento ideal para estos tipos de lesiones y la resonancia magnética de columna, un estudio útil para diagnosticar y tratar a los afectados.
The clinical case of a white 57 year-old patient is presented, with clinical pattern of dorsal medullary compression, reason why a laminectomy of D5-D7 was carried out, with resection of an extradural, rounded, wine colored lesion, of 3x2x2 cm. The results of the biopsy confirmed the diagnosis of an angiomatous malformation (cavernoma). Surgery is the ideal treatment for these types of lesions and the spine magnetic resonance is an useful study to diagnose and to treat those affected.
ABSTRACT
Spinal extradural cavernous angiomas(CAs) are apparently rare lesions. The author report a 67 year old man with an epidural CA at T9-10 space presenting with progressive leg weakness. Magnetic resonance imaging showed a thoracic epidural lesion appearing as isointense on T1-weighted with strong contrast enhancement and hyperintense on T2-weighted images. A moderate hyperdensity and foraminal widening was found on computed tomography. Hemilaminectomy was performed to relieve the spinal cord compression. A highly vascular tumor without bony involvement was observed in the epidural space. Histopathology of the lesion revealed a typical CA. The patient's symptoms resolved after treatment. Clinical aspect, radiological features, and surgical treatment of this rare entity will be reviewed.