Percutaneous Full-endoscopic Translamina Fenestration Approach for Treatment of A Lumbar Nerve Root Cyst and Literature Review

Wenbo Liao

doi:10.26717/bjstr.2019.19.003338

Abstract

Physiological basis of epidural nerve root cyst formation is certain developmental vulnerabilities of nerve root sleeve [1].

Highlights

Physiological basis of epidural nerve root cyst formation is certain developmental vulnerabilities of nerve root sleeve [1]
We report on a percutaneous full-endoscopic translamina fenestration approach combined Radio frequency (RF) for the treatment of lumbar nerve root cyst with a successful clinical outcome
The authors analyzed a rare case of a nerve root cyst that located in L2-3 intervertebral foramen, and here we report the usefulness of a percutaneous fullendoscopic translamina fenestration approach combined RF for the cyst

Summary

Introduction

Physiological basis of epidural nerve root cyst formation is certain developmental vulnerabilities of nerve root sleeve [1]. The medial pedicular line at the L2 vertebral level and the inferior edge of the L2 vertebral body were marked under image intensification, and body surface projection point of L2-3 left intervertebral foramen was decided, positioning needle was introduced and followed by expansion of the guide bar to the L2 vertebral plate, with a ring saw to establish bone windowl of work casing by the vertebral plate drilling (Figure 2), take away the window bone. We could see the decompressed nerve root (Figure 3).one day after the operation, the patient was ambulatory without feeble and pain, demonstrated the L3 nerve root was successfully decompressed, and the result was confirmed by postoperative MRI images (Figure 4a) Pathological studies showed a collagenous fibrous wall of a nerve root cyst without no synovial lining cell of inflammatory cell infiltration (Figure 4b). Lumbar MRI showed no recurrence of cysts and no abnormality of local spinal canal (Figure 5)

Discussion

Conclusion