CASE REPORTS   

Journal of Neurosurgical Sciences 2001 September;45(3):181-4

Copyright © 2001 EDIZIONI MINERVA MEDICA

lingua: Inglese

Nerve root compression by a gas-containing cyst associated with stenotic lateral recess. Case report and review of the literature

Qasho R. ¹, Santoro A. ², Vangelista T. ², Cantore G. ²

¹ Department of Neurological Sciences-Neurosurgery, Azienda Ospedaliera “S. Maria”, Terni, Italy; ² Department of Neurological Sciences-Neurosurgery I, University “La Sapienza”, Rome, Italy

The ­authors ­describe a ­case in ­which a gas-con­tain­ing ­cyst was asso­ciat­ed ­with a ste­not­ic lat­er­al ­recess at the ­same lev­el in the ­absence of any ­disc mate­ri­al. A ­young man pre­sent­ed a one-month his­to­ry of sciat­i­ca ­caused by com­pres­sion of the ­left L5 ­nerve ­root. The neu­ro­ra­dio­log­i­cal inves­ti­ga­tions per­formed (CT, MRI) ­showed the pres­ence of a gas-con­tain­ing ­cyst asso­ciat­ed ­with a ste­not­ic lat­er­al ­recess. The clin­i­cal, etio­path­o­log­i­cal char­ac­ter­is­tics and treat­ment of ­this con­di­tion are dis­cussed and the per­ti­nent lit­er­a­ture is ­reviewed. Decompression of the ­nerve ­root was ­obtained by sur­gery. The her­ni­at­ed gas col­lect­ed with­in a cap­sule (gas-con­tain­ing ­cyst) can act as a ­mass and pro­duce symp­toms, ­much ­like a her­ni­at­ed nucle­us pul­po­sus. The antal­gic ­stance adopt­ed by the ­patient ­with ­marked flex­ion of the ­spine ­helps to dis­trib­ute the pres­sure exert­ed by the ­cyst ­over a wid­er ­area (Pascal’s law I). The appro­pri­ate pro­ce­dure to ­relieve the radic­u­lar com­pres­sion ­caused by gas-containing ­cyst ­seemed to be the sur­gi­cal treat­ment.