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61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010
Joint Meeting mit der Brasilianischen Gesellschaft für Neurochirurgie am 20. September 2010

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

21. - 25.09.2010, Mannheim

Are lumbar synovial cysts a sign of segmental instability? A clinical evaluation in 40 patients

Meeting Abstract

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  • Martin Merkle - Klinik für Neurochirurgie, Universitätsklinikum Tübingen, Germany
  • Gottlieb Maier - Klinik für Neurochirurgie, Universitätsklinikum Tübingen, Germany
  • Marcos S. Tatagiba - Klinik für Neurochirurgie, Universitätsklinikum Tübingen, Germany
  • Florian Roser - Klinik für Neurochirurgie, Universitätsklinikum Tübingen, Germany

Deutsche Gesellschaft für Neurochirurgie. 61. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC) im Rahmen der Neurowoche 2010. Mannheim, 21.-25.09.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP1797

DOI: 10.3205/10dgnc268, URN: urn:nbn:de:0183-10dgnc2689

Veröffentlicht: 16. September 2010

© 2010 Merkle et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: Lumbar synovial cysts are frequently associated with segmental degenerative changes. Radiculopathy is the leading clinical presentation. However signs of instability are frequently present or arise after surgical decompression. We evaluate a series of patients with lumbar synovial cysts to elucidate if all patients need spinal fusion as primary treatment or if decompression is sufficient for a subset of patients.

Methods: Retrospective data of 40 patients treated during January 2004 to August 2009 were analysed (26 males, 24 females). All patients underwent a complete microsurgical resection of the synovial cyst by an interlaminar approach and a partial facetectomy. Fourteen patients showed additional degenerative spinal spondylolistesis requiring instrumentation in eight cases. The pre- and postoperative symptoms and imaging studies were reviewed.

Results: Most of the synovial cysts were at level L4/5. We found a strong correlation between degenerative spinal spondylolistesis and occurrence of synovial cysts. All patients presented with radiculopathy and local back pain, with 25% having neurological deficits. Postoperatively in thirty-four patients radiculopathy resolved, whereas back pain persisted in over 80%. These patients required secondary spinal fusion, reporting then about a marked remission of local back pain.

Conclusions: According to the literature the aetiology of synovial cysts is still unclear. However there seems to be a strong association for the development of a synovial cyst and spinal segmental instability. We can provide evidence that primary spinal fusion after resection of synovial cysts provides a better outcome.