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Online ISSN 1827-1707
Turtas S., Conti M., Zirattu G.
The interest of this case report is the extreme rarity of the involvement of the thoracic spine by iuxta-facet cyst. Moreover, the simultaneous occurrence of two adjacent cysts situated in the midline is exceptional. A 59-year-old man presented with a severe and progressive bilateral lower-extremity weakness, impaired sensation at the level of both hips and legs and urinary problems. Neurological examination revealed severe spastic paraparesis and epicritic hypoesthesia below T-8. Bilateral Babinski signs and clonus in both rotulae were exhibited. Diagnosis was ascertained by both Magnetic Resonance (MR) imaging and Computerized Tomography (CT) which revealed two epidural cysts adjacent to the D6-7 facets. The etiology of the iuxta-facet cysts, commonly attributed to osteoarthritic degenerative changes and/or to an increased joint motion, was not clear in the present case. CT findings observed in this case were similar to those more commonly described in the literature, while RM images were susceptible to show multifarious features. The conclusion is drawn that surgery of this very rare localization consists of a complete removal of the iuxta-facet cyst with a previous laminectomy of the adjacent thoracic vertebrae.