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Case Reports
. 2010 Aug 10:1:41.
doi: 10.4103/2152-7806.68338.

Successful treatment of a symptomatic L5/S1 discal cyst by percutaneous CT-guided aspiration

Hormuzdiyar H Dasenbrock  1 , Sudhir Kathuria, Timothy F Witham, Ziya L Gokaslan, Ali Bydon
Affiliations
Case Reports

Successful treatment of a symptomatic L5/S1 discal cyst by percutaneous CT-guided aspiration

Hormuzdiyar H Dasenbrock et al. Surg Neurol Int. .

Abstract

Background: Discal cysts are a rare cause of lumbar radiculopathy. Benefits of percutaneous computed tomography (CT)-guided aspiration of the cyst include decreased rate of infection, avoidance of general anesthesia, and quicker recovery. However, since the publication of a case of cyst recurrence after CT-guided aspiration, few have utilized this potentially valuable technique.

Case description: We present a patient with a discal cyst arising from the L5/S1 disc causing right S1 radiculopathy. He underwent percutaneous CT-guided aspiration with substantial improvement in his radicular pain with 19 months of follow-up. His improvement was measured quantitatively using the Japanese Orthopedic Association scale: 6/15 pre-procedure, 15/15 post-procedure.

Conclusion: Percutaneous CT-guided aspiration of discal cysts may be a valid initial treatment option for this condition. Patients who do not respond or who have a recurrence can subsequently be treated by surgical excision.

Keywords: CT-guided aspiration; disc cyst; discal cyst; intervertebral disc; percutaneous spinal interventions.

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Figures

Figure 1
Figure 1
T2-weighted magnetic resonance image of a patient with right-sided S1 radiculopathy. Sagittal (left) and transaxial (right) views at the level of the L5-S1 disc demonstrate a T2 hyperintense cystic structure (arrow) extending into the right ventrolateral extradural space
Figure 2
Figure 2
Fluoroscopy-guided L5-S1 discogram was performed from the contralateral (left) side. Lateral view reveals contrast filling into an intraspinal cyst-like outpouching from the disc
Figure 3
Figure 3
Transaxial computed tomography (CT) scan at the L5-S1 level. Before the CT-guided aspiration, the discal cyst is hyperdense (a). After CT-guided needle placement (b), the contents of the cyst were aspirated. Subsequently, the cyst is substantially smaller (c)
See this image and copyright information in PMC

References

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