Microsurgery via posterior approach for a case of multiple neuroradicular cysts at the thoracolumbar spine

YANG Xiao-yong; LIU Xiao-bo; LIAO Jin; ZHANG Yong; ZHOU Jie; WEI Hou-lu; DENG Lei

doi:10.13798/j.issn.1009-153X.2024.03.016

Abstract：Neuroradicular cysts are not common,and their formation is related to congenital developmental anomalies and trauma,and the"ball valve mechanism"theory is a reasonable mechanism for their formation.Most neuroradicular cysts have no clinical symptoms and do not require treatment.For those with clinical symptoms,surgery is recommended,but there is still controversy over the surgical method.This report describes a 59-year-old female who presented with multiple cysts at the thoracolumbar spine and right lower abdominal pain for over a year when in the left lateral position,with a visual analogue scale(VAS)score of 4.Thoracolumbar enhanced MRI showed multiple non-specifically enhanced cystic lesions at the bilateral T10/11 and right T12/L1 foramen.The patient had four cysts of varying sizes and locations,with the larger cyst in the right T10/11 intervertebral foramen causing symptoms of nerve root compression when the patient was in the left lateral position.The other three cysts did not cause any clinical symptoms.After completing preoperative preparations,the patient underwent a surgical treatment under general anesthesia,including partial resection of the cyst wall in the 10/11 intervertebral foramen on the right side,nerve root sleeve formation,and autologous fat-muscle-protein gel cyst filling.The patient's right lower abdominal pain disappeared 6 hours after the surgery,and a telephone follow-up 3 months after the surgery revealed no recurrence of right lower abdominal pain.This suggests that for neuroradicular cysts with symptoms,partial resection of the cyst wall and autologous fat-muscle-protein gel cyst filling can achieve satisfactory outcomes.