Gas-filled intradural cysts of the lumbar spine and the possible pathogenesis
Received 26 May 2008; accepted 14 January 2009. published online 02 March 2009.
Abstract
Background context
There have only been four reports of gas-filled intradural cysts, and the pathogenesis is unknown.
Purpose
To document the radiologic and histopathologic features of gas-filled intradural cysts and to discuss the pathogenesis with a review of the literature.
Study design
Case report.
Methods
A 67-year-old woman, admitted to our institute, presented with severe right thigh pain. On admission to the institute, enhanced magnetic resonance imaging, showed a cystic lesion in the spinal canal at the L2–L3 level, with an intensity suggesting the presence of gas. An enhanced region around the cyst was noted. Computed tomography after discography also revealed a water-soluble contrast filled the subarachnoid space and area around the cyst, but not inside.
Results
The cyst was surgically resected. One of the nerve roots was firmly adherent to the gas-filled cyst. The cyst wall comprised fibrous tissue, including small granulations and herniated disc material.
Conclusion
Gas-filled intradural cysts are rare. The pathogenesis appears to involve gas in a degenerated intervertebral disc, and spontaneous absorption of herniated disc material.
Department of Orthopaedic and Neuro-Musculoskeletal Surgery, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan
Corresponding author. Department of Orthopaedic and Neuro-Musculoskeletal Surgery, Faculty of Medical and Pharmaceutical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto 860-8556, Japan. Tel.: (81) 96-373-5226; fax: (81) 96-373-5228.
ABSTRACT