An Extradural Cyst of Lumbar Spine(Associated with Ruptured Intervertebral Disc): Report of One Case

ABSTRACT

We experienced a case of an extradural cyst of lumbar spine associated with a freshly ruptured intervertebral disc on L3-4 intervertebral space. A 22-years old Korean female was admitted to hospital because of low back pain radiating to the both legs for about 7 weeks, after mild trauma in the running bus. The low back pain and bilateral sciatic pain had aggravated by coughing and sneezing, similar to the protruded intervertebral disc. Neurological examination revealed the signs similar to those of the protruded intervertebral disc. Simple X-ray films of lumbar spine revealed scoliosis, stretching of lumbar lordotic curve. Myelography showed a complete block from lower one third of L3 vertebral body to upper one fourth of L4 vertebral body by spinal puncture of L2-3 and L5-S1 interspace, respectively. We performed a total laminectomy of L3-4 for the above lesion. The operative finding showed an extradural cyst adhesive with L3 nerve root sheath and freshly ruptured intervertebral disc on L3-4 interspace. The extradural cyst was 2.0x1.5x0.5cm in size and its surface was not smooth but coarse. The contents of cyst was yellowish brown fluid(xanthochromic). We removed the extradural cyst completely and the ruptured(tiny tagged) contents of nucleus pulposus. The post-operative course was satisfactory, dramatically. The microscopic findings of the extradural cyst showed a simple cyst including a profuse pigments of hemosiderin, highly suggested one formed from and epidural hematoma by trauma.