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Nerve root compression by a ganglion cyst of the lumbar anulus fibrosus. A case report
1Orthopaedic Associates of Osceola, Kissimmee, Florida, USA.
Study Design:
A case report of a ganglion cyst rising from the anulus pulposus, causing lumbar nerve root compression.
Objectives:
A rare pathologic condition causing sciatica is described. The pathologic anatomy and the magnetic resonance image of the lesion is discussed.
Summary Of Background Data:
A 35-year-old man was subjected to an abrupt twisting motion of the torso during a motor vehicle accident. The patient had a L5-S1 discectomy 1 year before the accident. His low back discomfort and right lower extremity pain were clearly exacerbated by the recent trauma.
Methods:
Magnetic resonance imaging revealed enhancing lobulated epidural mass displacing the S1 nerve.
Results:
Intraoperative findings were a lobulated cystic mass rising from the degenerated anulus fibrosus, determined on histologic examination to be a ganglion cyst. The patient noted significant relief of the right sciatica after surgery.
Conclusion:
The appearance and the signal intensity of the epidural mass appear to be important parameters in diagnosing the presence of a ganglion cyst of the anulus fibrous. Excision of the ganglion cyst is indicated in a patient who fails to respond to conservative treatment and where the symptoms correlate with the abnormality seen with magnetic resonance imaging.