A rare clinical case of surgical treatment of a periarticular cyst of the facet joint of the lumbar spine
- Authors: Potapov V.E.1, Koshkareva Z.V.1, Zhivotenko A.P.1, Sklyarenko O.V.1, Gorbunov A.V.1, Glotov S.D.1, Sorokovikov V.A.1,2
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Affiliations:
- Irkutsk Scientific Centre of Surgery and Traumatology
- Irkutsk State Medical Academy of Postgraduate Education – Branch Campus of the Russian Medical Academy of Continuing Professional Education
- Issue: Vol 10, No 2 (2019)
- Pages: 97-103
- Section: Case reports
- URL: https://journals.rcsi.science/clinpractice/article/view/15203
- DOI: https://doi.org/10.17816/clinpract10297-103
- ID: 15203
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Abstract
Background. Periarticular cysts of the facet joint, due to their rare occurrence, often slip away from the attention of clinicians. However their formation and progression may cause compression of vascular-neural structures with subsequent manifestations of severe neurological disorders.
Description of the clinical case. We present a rare clinical case of surgical treatment of a periarticular cyst of the facet joint. A comprehensive examination of the patient S. revealed: Dorsopathy with degenerative spinal canal stenosis at LV-SI level; spondyloarthrosis; periarticular facet cyst at LV-SI level on the left; radiculopathy LV on the left, in the acute stage; pronounced pain and musculo-tonic syndrome. Complaints of the patient: constant pain in the lumbar spine, extending to the left lower extremity and aggravating when walking at a distance of 50-100 meters; feeling numb when walking on the plantar surface of the left foot. When examining the local status, a forced posture with a bowed head and torso forward was noted; smooth lumbar lordosis and antalgic right-sided scoliosis; tension of paravertebral muscles. Neurological examination revealed LVradiculopathy on the left with moderate paresis of the extensor muscles of the left foot and ipsilateral Lasègue's positive test. MRI examination revealed spinal canal stenosis, facet joint cyst at the level of LV-SI with dimensions of 14×8×8.5 mm. An operative intervention was performed: reconstructive decompressive-stabilizing spinal surgery with a single block removing the articular facet with a periarticular cyst at the left LV-SI level with subsequent posterior transpedicular fixation of the vertebral motor segment. Two months after the operation, complete medical and social rehabilitation of the patient was achieved. No complaints.
Conclusion. In case of compression of a periarticular cyst of vascular-neural structures with severe neurological disorders, surgical treatment with the cyst removal is recommended.
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##article.viewOnOriginalSite##About the authors
Vitaliy E. Potapov
Irkutsk Scientific Centre of Surgery and Traumatology
Email: pva454@yandex.ru
ORCID iD: 0000-0001-9167-637X
Candidate of Medical Sciences, Head of Neurosurgical Unit, Leading Research Officer at the Research Clinical Department of Neurosurgery
Russian Federation, IrkutskZinaida V. Koshkareva
Irkutsk Scientific Centre of Surgery and Traumatology
Email: zina.koshkareva1941@mail.ru
ORCID iD: 0000-0002-4387-5048
канд. мед. наук, ведущий науч. сотр. научно-клинического отдела нейрохирургии
Russian Federation, IrkutskAleksandr P. Zhivotenko
Irkutsk Scientific Centre of Surgery and Traumatology
Author for correspondence.
Email: sivotenko1976@mail.ru
ORCID iD: 0000-0002-4032-8575
SPIN-code: 8016-5626
мл. науч. сотр. научно-клинического отдела нейрохирургии
Russian Federation, IrkutskOksana V. Sklyarenko
Irkutsk Scientific Centre of Surgery and Traumatology
Email: oxanasklyarenko@mail.ru
ORCID iD: 0000-0003-1077-7369
канд. мед. наук, старший научный сотрудник научно-клинического отдела нейрохирургии
Russian Federation, IrkutskAnatoly V. Gorbunov
Irkutsk Scientific Centre of Surgery and Traumatology
Email: a.v.gorbunov58@mail.ru
ORCID iD: 0000-0002-1352-0502
врач-нейрохирург нейрохирургического отделения, мл. науч. сотр. научно-клинического отдела нейрохирургии
Russian Federation, IrkutskSergey D. Glotov
Irkutsk Scientific Centre of Surgery and Traumatology
Email: glotovsd@gmail.com
врач-нейрохирург нейрохирургического отделения
Russian Federation, IrkutskVladimir A. Sorokovikov
Irkutsk Scientific Centre of Surgery and Traumatology; Irkutsk State Medical Academy of Postgraduate Education – Branch Campus of the Russian Medical Academy of Continuing Professional Education
Email: vasorokovikov@mail.ru
ORCID iD: 0000-0002-9008-6383
д-р мед. наук, профессор, директор; зав. кафедрой травматологии, ортопедии и нейрохирургии
Russian Federation, IrkutskReferences
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