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Published on: October 20, 2023
Extreme intraneural ganglion cysts
Robert J Spinner1, Marie-Noëlle Hébert-Blouin, Michael G Rock
1Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA. spinner.robert@mayo.edu
Journal of Neurosurgery
|May 22, 2010
Summary
Extensive intraneural ganglia originate from the superior tibiofibular joint and can be successfully treated by resecting the joint and disconnecting the articular branch, not by cyst resection.
Area of Science:
- Neurology
- Orthopedic Surgery
- Radiology
Background:
- Intraneural ganglia with extensive longitudinal involvement are poorly understood.
- Previous treatments like cyst decompression and resection led to recurrence and poor outcomes.
Observation:
- Two cases of extensive intraneural ganglia involving tibial and peroneal nerves are presented.
- MR imaging and arthrography confirmed joint origins from the superior tibiofibular joint (STFJ).
Findings:
- Extreme intraneural cysts follow the same principles as typical ganglia, originating from the STFJ.
- High intraarticular pressures in degenerative joints likely cause extensive longitudinal spread.
- Successful treatment involved disconnecting the articular branch and resecting the STFJ.
Implications:
- This study clarifies the pathogenesis of extensive intraneural ganglia.
- A minimally invasive surgical approach targeting the joint of origin offers successful treatment.
- Understanding the articular connection is crucial for managing these complex nerve cysts.
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