• Journal of Korean Neurosurgical Society
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• v.51 no.4
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• pp.208-214
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• 2012

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 $8.25{\pm}0.5$. At the last examination followed longer than 6 month, the mean VAS for leg pain was $2.25{\pm}2.21$. 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.

• The Korean Journal of Pain
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• v.29 no.2
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• pp.129-135
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• 2016

Although discal cysts are a rare cause of low back pain and radiculopathy. Currently, surgical excision is usually the first-line treatment for discal cysts. However, alternative treatment methods have been suggested, as in some cases symptoms have improved with interventional therapies. A 27-year-old man presented with an acute onset of severe pain, and was found to have a discal cyst after an open discectomy. The patient underwent cyst aspiration and steroid injection through the facet joint under C-arm guidance. After the procedure, the patient's pain improved to NRS 0-1. On outpatient physical examination 1 week, and 1 and 3 months later, no abnormal neurological symptoms were present, and pain did not persist; thus, follow-up observation was terminated. When a discal cyst is diagnosed, it is more appropriate to consider interventional management instead of surgery as a first-line treatment, while planning for surgical resection if the symptoms do not improve or accompanying neurologic deficits progress.

• The Korean Journal of Pain
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• v.27 no.1
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• pp.86-89
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• 2014

Discal cyst is an intraspinal cyst with a distinct communication with the corresponding intervertebral disc. It is a rare condition and could present with radiculopathy similar to that caused by lumbar disc herniation. We present a patient with a large discal cyst in the ventrolateral epidural space of the $5^{th}$ lumbar vertebral (L5) level that communicated with the adjacent $4^{th}$ lumbar and $5^{th}$ lumbar intervertebral disc, causing L5 radiculopathy. We alleviated the radiating pain with selective transforaminal epidural blocks.

• Journal of Korean Neurosurgical Society
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• v.53 no.4
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• pp.255-257
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• 2013

Lumbar discal cyst is a rare cause of radiculopathy. Their exact pathogenesis and the optimal treatment modality remain unidentified. Depending on their location, discal cysts cannot always be easily identified intraoperatively. We describe 2 patients with discal cysts and introduce an intraoperative discography technique for discal cyst location. Both patients were treated with surgical excision; with intraoperative discography, the cystic lesions could easily be detected and removed.

• Journal of Korean Neurosurgical Society
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• v.44 no.4
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• pp.262-264
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• 2008

Discal cysts are rare lesions that can cause radiating leg pain. Because they are very rare, their natural history and the details of the therapeutic guidelines for the treatment of these cysts are still unknown. A 30-year-old male patient presented to our institute with radiating pain in his left leg and mild back pain. Magnetic resonance imaging (MRI) revealed an intraspinal extradural cystic mass with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images at the L5-S1 level. The partial hemilaminectomy and cyst resection were performed. We report a patient with low back pain and radiating leg pain caused by a lumbar discal cyst and discuss the treatment of this cyst.

• Journal of Korean Neurosurgical Society
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• v.41 no.6
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• pp.418-420
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• 2007

Discal cyst is a very rare lesion that can result in refractory low back pain and leg radiating pain. Because they are so uncommon, their exact origin and pathophysiology are still unknown. A 31-year-old man visited our institute due to low back pain and severe left leg radiating pain. Magnetic resonance images [MRI] revealed spherically shaped extradural cystic lesion at L2-L3 level. Computed tomography [CT] discography demonstrated obvious communication between the intervertebral disc and the cyst. The patient underwent posterior decompression and excision of cyst. The symptoms were remarkably improved immediately after surgery.

• Journal of Veterinary Clinics
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• v.31 no.5
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• pp.445-448
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• 2014

A 7-year-old, male Alaskan malamute was referred for a routine dental management. On the physical examination, the right hindlimb ataxia with a mild delay in proprioception was noted. On magnetic resonance images, an extradural ventral cystic structure compressing the spinal cord was found at the level between the first and second lumbar vertebra. The cyst showed hypointense on a T1-weighted image with rim enhancement and hyperintense on a T2-weighted image. The cystic lesion was removed through right-side hemilaminectomy. In the histopathological examination, evenly distributed fibroblasts and collagenous stroma with several cartilaginous materials were seen. The neurological signs of the right hindlimb were successfully recovered within a week in follow-up neurological examination and showed normal gait at 6 months after surgery.