Related Experiment Video
Updated: Jun 24, 2026
C-arm-Free Simultaneous OLIF51 and Percutaneous Pedicle Screw Fixation in a Single Lateral Position
Published on: September 16, 2022
Pigmented villonodular synovitis of a lumbar intervertebral facet joint
Ahmet Murat Müslüman1, Halit Cavuşoğlu, Adem Yilmaz
1Neurosurgery Clinic, Sişli Etfal Education and Research Hospital, Istanbul, Turkey.
Background Context:
Pigmented villonodular synovitis (PVNS) is a slowly progressive lesion of uncertain etiology that involves the synovial membrane of joints or tendon sheaths. Only rarely does PVNS affect the axial skeleton, where it arises from the vertebral articular facet joint. Its treatment and prognosis remains limited.
Purpose:
To describe our management in a patient with PVNS and to review previously published cases.
Study Design:
Case report.
Methods:
This is a case report of a 59-year-old woman who presented left sciatica. Computed tomography (CT) imaging revealed a mixed sclerotic and lucent lesion affecting the left L4-L5 facet joint. Magnetic resonance imaging (MRI) demonstrated a diffusely infiltrative process that originated from the left inferior articular process of L4 vertebra with extension into the spinal canal. A total synovectomy with left L4 hemilaminectomy was performed. Left L5 root was decompressed with total microscopic tumor removal. Decompression of spinal canal and absence of the tumor was shown by MRI and CT scan after the operation.
Results:
Complete resolution of the patient's complaints was achieved. Histopathological analysis was consistent with a diagnosis of PVNS.
Conclusions:
The principle of surgical management of spinal lesions causing neurologic deficit is early surgical decompression. It is also important to totally remove the synovium, the origin of PVNS, to prevent the recurrence.
Related Concept Videos
01:29Herniated Intervertebral Disc l: Introduction
01:23Degenerative Disc Disease ll: Pathophysiology
01:27Degenerative Disc Disease I: Introduction
01:09Functional Classification of Joints
The functional classification of joints is determined by the amount of mobility between the adjacent bones. Joints are functionally classified as a synarthrosis or immobile joint, an amphiarthrosis or slightly moveable joint, or as a diarthrosis, a freely moveable joint. Fibrous and cartilaginous joints can be functionally classified as either synarthroses or amphiarthroses, whereas all synovial joints are classified as diarthroses.
Synarthrosis
An immobile...
01:11Fibril-associated Collagen
For example, the type II collagen fibrils in cartilage have covalently bound type IX fibril-associated collagens at regular intervals. Other types of fibril-associated collagens are...
01:07Development of the Limb Synovial Joints
The mesenchymal stem cells differentiate into chondrocytes that form the hyaline cartilage, and later the cartilaginous model of the bone. This model further transforms into a bone. This process is known as endochondral ossification.
During development, the limbs...