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首页> 美国卫生研究院文献>Clinics and Practice >Intraspinal Lumbar Juxtaarticular Cyst Treatment Through CT-Guided Percutaneus Induced Rupture Results in a Favorable Patient Outcome
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Intraspinal Lumbar Juxtaarticular Cyst Treatment Through CT-Guided Percutaneus Induced Rupture Results in a Favorable Patient Outcome

机译：通过CT引导的经皮诱发的破裂引起的椎管内腰突关节囊肿治疗对患者有利

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Juxta-articular cysts are synovial cysts originating from the facet joints or the flava ligaments. If they grow intra-spinally they can compress nervous structures and cause a variety of symptoms. Micro-neurosurgery is usually the treatment of choice. Alternatively to surgical treatment the cyst can be approached and treated with a CT guided percutaneous injection inducing rupture. After fulfilling strict selection criteria twenty patients (25% of all treated lumbar synovial cyst patients), were treated minimally invasive by this method from 2010-2016. The facet joint was punctured under CT guidance and a mixture of a local anesthetic and contrast liquid was injected until the cyst was blasted. The mean follow-up period was 1.1 years (range 2 weeks - 5 years).Fifteen of twenty procedures were successful and cyst rupture was confirmed by CT-scans. Twelve of these fifteen patients experienced a significant improvement of their symptoms and needed no further intervention or surgical procedure up until now, three patients showed no clinical improvement and were treated surgically within one week after cyst rupture. In five patients it was technically not possible to rupture the cyst. These patients were treated microsurgically by cyst resection and dynamic stabilization or fusion procedures. The percutaneus rupture of juxtaarticular cysts has fewer risks and is cost effective compared to microsurgical resection. It may be an alternative to surgical treatment for a selected group of patients. However there are some limitations to the procedure though, such as difficult patient selection, unpredictable outcome or technical problems due to highly degenerated facet joints.
机译：并列关节囊肿是滑膜囊肿，起源于小关节或韧带韧带。如果它们在脊髓内生长，则会压迫神经结构并引起多种症状。显微神经外科通常是治疗的选择。除手术治疗外，囊肿可通过CT引导的经皮注射诱导破裂并接近并治疗。在满足严格的选择标准后，从2010年至2016年，通过这种方法对20例患者（占所有治疗的腰滑膜囊肿患者的25％）进行了微创治疗。在CT引导下穿刺小关节，并注入局麻药和造影剂的混合物，直到囊肿被爆破。平均随访时间为1.1年（2周至5年）.20例手术中有15例成功，并且CT扫描证实了囊肿破裂。在这15名患者中，有12名患者的症状得到了明显改善，到目前为止，无需进一步干预或外科手术。3名患者的临床表现没有改善，在囊肿破裂后一周内接受了手术治疗。在五名患者中，技术上不可能使囊肿破裂。通过囊肿切除和动态稳定或融合手术对这些患者进行了显微手术治疗。与显微外科手术切除相比，经皮囊状近囊破裂的风险较小且具有成本效益。对于选定的一组患者，它可以替代手术治疗。但是，该过程仍然存在一些局限性，例如患者选择困难，结节高度退化导致不可预测的结果或技术问题。

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