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Endoscopic transforaminal treatment of a thoracic perineural cyst: a case report
Raymond J Gardocki1, Philip J Chandler2, Wilson E Vaughan1
1Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Medical Center East, South Tower, Suite 4200, Nashville, TN, 37232-8774, USA.
Background And Importance:
To describe the first case of a thoracic perineural cyst successfully treated using a direct thoracic transforaminal endoscopic approach.
Methods:
Case report.
Clinical Presentation:
A 66-year-old male presented with right-sided radicular pain in a T4 distribution. MRI of the thoracic spine revealed a right T4 perineural cyst caudally displacing the root in the T4-5 foramen. He had failed attempts at nonoperative management. The patient underwent an all endoscopic transforaminal perineural cyst decompression and resection as a same-day surgical procedure. Postoperatively, the patient noted near complete resolution of the preoperative radicular pain. A thoracic MRI with and without contrast was performed 3 months after surgery and showed no evidence of the preoperative perineural cyst and no symptom recurrence was noted by the patient.
Conclusion:
This case report presents the first safe and successful report of an all endoscopic transforaminal decompression and resection of a perineural cyst in the thoracic spine.
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