scholarly journals Surgically Managed Symptomatic Intraspinal Lumbar Facet Synovial Cyst: Outcome of surgical treatment with resection and instrumented posterolateral fusion, a case series.

2021 ◽  
Author(s):  
Lyonel Beaulieu Lalanne ◽  
Facundo Alvarez Lemos ◽  
Roberto Larrondo Carmona ◽  
Juan Ignacio Cirillo Totera ◽  
Andre Beaulieu Montoya ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Retrospective Review ◽  
Symptom Relief ◽  
Case Series ◽  
Synovial Cyst ◽  
Lumbar Region ◽  
Number Of Patients ◽  
Surgical Data ◽  
Synovial Cysts ◽  
Axial Pain

Abstract PURPOSE: There is controversy regarding the treatment of symptomatic synovial cysts (SSC), specifically, the need for a concomitant fusion when surgical resection of the CS is required. We present a retrospective review of a series of patients treated for SSC of the lumbar region during the last 20 years by a single surgeon, analyzing the current available literature. METHODS: Retrospective review. The same surgical technique was applied to all patients. Demographic, clinical, surgical data and synovial cyst recurrence rate were recorded. Postoperative results reported by patients were documented according to the McNab score. RESULTS: 69 subjects, with mean follow-up of 7.4 years. 62% (43) were female, with a mean 57.8 years at the time of surgery. In 91.3% (63), the primary management was conservative for a minimum period of 3 months. All subjects underwent surgery due to the failure of conservative treatment. The segment most operated on was L4-L5 (63.77%). 91.3% (63) of the sample reported excellent and good and 6 subjects (8.6%) fair or poor results. There was no evidence of CS recurrence at the operated level. CONCLUSION: In SSC, it seems that conservative treatment is only effective in a limited number of patients and in the short term. Thus, the recommendation of a surgical indication should proceed as soon as the conservative management fails to result in significant symptom relief. Based on our results, we recommend, together with the resection of the cyst, the instrumentation of the segment to avoid its recurrence and the management of axial pain.

scholarly journals A novel approach to symptomatic lumbar facet joint synovial cyst injection and rupture using iGuide navigational software: A case report and review

2016 ◽  
Vol 22 (5) ◽  
pp. 596-599
Author(s):  
David J Wang ◽  
Stephen P Lownie ◽  
David Pelz ◽  
Sachin Pandey
Keyword(s):  
Facet Joint ◽  
Symptom Relief ◽  
Percutaneous Treatment ◽  
Synovial Cyst ◽  
Neurogenic Claudication ◽  
Novel Approach ◽  
Successful Approach ◽  
Synovial Cysts ◽  
Cyst Rupture ◽  
Lumbar Facet

Spinal synovial cysts are benign protrusions of facet joint capsules caused by degenerative spondylosis, most frequently involving the L4–5 level, and commonly lead to symptoms of back pain, radiculopathy and neurogenic claudication. Although percutaneous treatment via facet joint steroid injection with cyst rupture can provide significant symptom relief, cyst rupture is not always achievable via an indirect trans-facet approach due to limited access from severe degenerative changes. In this case, we describe a successful approach to direct cyst access using a laser-guided navigational software in a patient with severe facet joint osteophytosis. We provide a brief review of literature.

scholarly journals Intradural synovial cyst of the upper cervical spine: A rare cause of symptomatic cord compression

2020 ◽  
Vol 11 ◽  
pp. 190
Author(s):  
Yahya H. Khormi ◽  
Ryan Chrenek ◽  
Sankar Tejas
Keyword(s):  
Synovial Cyst ◽  
Cord Compression ◽  
Neurophysiological Monitoring ◽  
Posterior Arch ◽  
Upper Cervical Spine ◽  
Histopathological Diagnosis ◽  
Lumbar Region ◽  
Cyst Excision ◽  
Upper Cervical ◽  
Synovial Cysts

Background: Synovial cysts are commonly observed soft-tissue masses of the spine, typically extradural and located in the lumbar region. We describe a very rare symptomatic case of a C1-C2 intradural synovial cyst. Case Description: A 78-year-old female presented with progressive left side weakness, paresthesia, and hyperreflexia. The magnetic resonance imaging revealed a well-circumscribed, subtly enhancing lesion medial to the C1-2 facet, causing cord compression and edema. Using neurophysiological monitoring, surgery included a modified laminectomy of C2 with the removal of the C1 posterior arch. When the dura was opened, a sizable intradural extramedullary lesion was encountered, the cyst was successfully drained and partially resected. The histopathological diagnosis was consistent with a synovial cyst. Postoperatively, the patient’s strength on the left side improved gradually until she was fully ambulatory. Postoperative imaging showed no recurrence at 8 months follow-up. Conclusion: Synovial cysts should be considered among the differential diagnose of C1-2 cysts. They can occur intradurally and compress the spinal cord resulting in a significant neurological deficit. Cyst excision may be accomplished utilizing a limited laminectomy for cyst identification and drainage, accompanied by partial resection of the cyst wall. Such intervention can lead to good clinical outcomes.

Arthroscopic Resection of Wrist Volar Synovial Cyst: Technique Description and Case Series

2021 ◽  
Author(s):  
Ricardo Kaempf de Oliveira ◽  
João Pedro Farina Brunelli ◽  
Vicente Carratalá ◽  
Márcio Aita ◽  
Gustavo Mantovani ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Case Series ◽  
Invasive Procedure ◽  
Synovial Cyst ◽  
Good Alternative ◽  
Open Technique ◽  
Small Joint ◽  
Safe Technique ◽  
Synovial Cysts

Abstract Background Arthroscopy nowadays has become a widespread technique for the treatment of orthopaedic pathologies. Small-joint arthroscopy has evolved and, through direct visualization, enables diagnosis and immediate treatment of intra-articular lesions. The arthroscopic resection has become a minimally invasive alternative for the open technique. We intend to describe the technique, literature review, and results of arthroscopy for the surgical treatment of wrist volar synovial cysts. Methods Thirty-nine patients submitted to arthroscopy for the treatment of wrist volar synovial cyst were included and assessed in this study, during the period of January 2015 to May 2017 with a complete assessment in minimum follow-up of 6 months. The technique was indicated for patients with pain and functional impairment for longer than 4 months, with no improvement with conservative measures, or for patients with cosmetic complaints, or those who presented the cyst for more than 3 months. Results We demonstrated good outcomes in regard to pain, range of motion, and complications in arthroscopic resection of volar wrist ganglion. Conclusion Arthroscopic resection of volar synovial is a useful and safe technique. It is a low-morbidity, minimally invasive procedure that carries few complications and is a good alternative to the open technique.

scholarly journals Characteristics and surgical outcomes of cleft palate in kabuki syndrome: a case series of 11 patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jong-Ho Kim ◽  
Jiwon Kang ◽  
Joon Seok Oh ◽  
Taeseon Ahn ◽  
Baek-kyu Kim ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Surgical Outcomes ◽  
Case Series ◽  
Speech Development ◽  
Velopharyngeal Insufficiency ◽  
Flap Surgery ◽  
Number Of Patients ◽  
Significant Difference ◽  
Surgical Data ◽  
Pharyngeal Flap

Abstract Objective A significant number of patients with KS have cleft palate (CP) or submucous cleft palate (SMCP) and show delayed speech development. However, few reports have discussed the characteristics of CP in KS and the outcomes of postoperative speech development. The purpose of this study was to investigate the characteristics and surgical outcomes of CP in patients with KS, and to discuss the importance of the diagnosis of CP or SMCP. Methods We conducted a retrospective study on patients with clinically diagnosed KS who underwent palatoplasty. Clinical and surgical data were collected from patients’ medical records, and velopharyngeal function was evaluated using nasopharyngoscopy and speech analysis. Results In 11 cases, 5 patients had CP (45.5%) and 6 had SMCP (54.5%). Four patients who were genetically tested had a pathogenic variant of KMT2D. Seven of nine patients (77.8%) who underwent conventional palatoplasty showed velopharyngeal insufficiency and hypernasality. All patients who underwent pharyngeal flap surgery achieved velopharyngeal competency. Statistical analysis revealed a statistically significant difference in postoperative results between non-syndromic and KS patients. Conclusion Patients with SMCP may be more common than previously reported. The results showed that it is difficult to produce optimal results with conventional palatoplasty; therefore, pharyngeal flap surgery should be considered as a treatment to obtain favorable results. Pharyngeal flap surgery in patients with KS should be carefully designed based on speech evaluation and nasopharyngoscopic findings.

scholarly journals SCLEROTHERAPY WITH 75% HYPERTONIC GLUCOSE TO TREAT DORSAL SYNOVIAL CYSTS OF THE WRIST

2021 ◽  
Vol 29 (2) ◽  
pp. 101-104
Author(s):  
FERNANDO ARAUJO PIRES ◽  
JOÃO BAPTISTA GOMES DOS SANTOS ◽  
CARLOS HENRIQUE FERNANDES ◽  
LUIS RENATO NAKASHIMA ◽  
FLÁVIO FALOPPA
Keyword(s):  
Hand Function ◽  
Case Series ◽  
Synovial Cyst ◽  
Cure Rate ◽  
Level Of Evidence ◽  
Hypertonic Glucose ◽  
Percutaneous Sclerotherapy ◽  
Previous Trauma ◽  
History Of ◽  
Synovial Cysts

ABSTRACT Objective: To evaluate the cure rate for dorsal synovial cysts of the wrist with aspiration and percutaneous sclerotherapy using 75% hypertonic glucose. Methods: We enrolled 45 patients older than 18 years with untreated dorsal synovial cysts of the wrist. They underwent percutaneous aspiration and sclerotherapy with 75% hypertonic glucose 75%. A maximum of two procedures were conducted for each cyst at a 4-week interval. We analyzed age, sex, affected side, history of previous trauma, wrist goniometry, grip strength, wrist pain by the visual analogue scale, complications, and hand function questionnaire scores. Results: We evaluated 45 patients (30 female, 15 male, mean age 38.2 years with 47 cysts). Four weeks after the first procedure, 72.3% cysts were palpable and visible. At 24 weeks after the first procedure, 57.4% cysts evolved to cure and 42.6% persisted. Conclusion: Treatment of dorsal synovial cyst of the wrist with aspiration and percutaneous sclerotherapy using 75% hypertonic glucose achieved a 57.4% cure rate after 24 weeks. Level of Evidence IV, Case series

Synovial Cyst of a Cervical Facet Joint: Case Report

Neurosurgery ◽  
1985 ◽  
Vol 16 (6) ◽  
pp. 850-852 ◽  
Author(s):  
Mont J. Cartwright ◽  
Daniel G. Nehls ◽  
Carlos A. Carrion ◽  
Robert F. Spetzler
Keyword(s):  
Case Report ◽  
Facet Joint ◽  
Spastic Paraparesis ◽  
Synovial Cyst ◽  
Cervical Spine Fracture ◽  
Lumbar Region ◽  
Synovial Cysts ◽  
Cervical Facet ◽  
Cervical Facet Joint ◽  
Satisfactory Recovery

Abstract Intraspinal synovial cysts are rare. Those reported have occurred in the lumbar region. We report a case of an extradural true synovial cyst of the cevical spine causing spastic paraparesis. The cyst occurred after a cervical spine fracture and, hence, was probably related to trauma. Surgical therapy resulted in a satisfactory recovery.

Clinical outcomes and prognostic factors for cavernous hemangiomas of the spinal cord: a retrospective cohort study

2019 ◽  
Vol 31 (2) ◽  
pp. 271-278 ◽  
Author(s):  
Narihito Nagoshi ◽  
Osahiko Tsuji ◽  
Daisuke Nakashima ◽  
Ayano Takeuchi ◽  
Kaori Kameyama ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Surgical Intervention ◽  
Lesion Size ◽  
Sudden Onset ◽  
Neurological Function ◽  
Neurological Injury ◽  
Prognostic Indicators ◽  
Asymptomatic Patients ◽  
Surgical Data ◽  
Unstable Gait

OBJECTIVEIntramedullary cavernous hemangioma (CH) is a rare vascular lesion that is mainly characterized by the sudden onset of hemorrhage in young, asymptomatic patients, who then experience serious neurological deterioration. Despite the severity of this condition, the therapeutic approach and timing of intervention for CH remain matters of debate. The aim of this study was to evaluate the clinical characteristics of CH patients before and after surgery and to identify prognostic indicators that affect neurological function in these patients.METHODSThis single-center retrospective study included 66 patients who were treated for intramedullary CH. Among them, 57 underwent surgery and 9 patients received conservative treatment. The authors collected demographic, symptomology, imaging, neurological, and surgical data. Univariate and multivariate logistic regression analyses were performed to identify the prognostic indicators for neurological function.RESULTSWhen comparing patients with stable and unstable gait prior to surgery, patients with unstable gait had a higher frequency of hemorrhagic episodes (52.4% vs 19.4%, p = 0.010), as assessed by the modified McCormick Scale. The lesion was significantly smaller in patients who underwent conservative treatment compared with surgery (2.5 ± 1.5 mm vs 5.9 ± 4.1 mm, respectively; p = 0.024). Overall, the patients experienced significant neurological recovery after surgery, but a worse preoperative neurological status was identified as an indicator affecting surgical outcomes by multivariate analysis (OR 10.77, 95% CI 2.88–40.36, p < 0.001). In addition, a larger lesion size was significantly associated with poor functional recovery in patients who had an unstable gait prior to surgery (8.6 ± 4.5 mm vs 3.5 ± 1.6 mm, p = 0.011).CONCLUSIONSOnce a hemorrhage occurs, surgical intervention should be considered to avoid recurrence of the bleeding and further neurological injury. In contrast, if the patients with larger lesion presented with worse preoperative functional status, surgical intervention could have a risk for aggravating the functional deficiencies by damaging the thinning cord parenchyma. Conservative treatment may be selected if the lesion is small, but regular neurological examination by MRI is needed for assessment of a change in lesion size and for detection of functional deterioration.

scholarly journals Is Biofeedback through an Intra-Aural Device an Effective Method to Treat Bruxism? Case Series and Initial Experience

2020 ◽  
Vol 18 (1) ◽  
pp. 51
Author(s):  
Kira Pfeiffer ◽  
Thaqif El Khassawna ◽  
Deeksha Malhan ◽  
Christine Langer ◽  
Barbara Sommer ◽  
...  
Keyword(s):  
Clinical Evidence ◽  
Positive Impact ◽  
Case Series ◽  
Physiological Status ◽  
Initial Experience ◽  
Ear Canal ◽  
Number Of Patients ◽  
Patient Reported ◽  
Unpleasant Feeling ◽  
Ear Canals

Biofeedback was reported as an effective concept for bruxism treatment, through increasing patient’s awareness of the habit. During bruxing both ear canals become tighter, therefore, an in-ear device can provide biofeedback. The in-ear device is fitted to the ear canal in physiological status, during bruxing the ear-canal tightens resulting in stress on the canal walls and unpleasant feeling. Subsequently, patients stop their bruxing habit. The aim of this study is to provide first clinical evidence that in-ear devices have a positive impact on relieving bruxism in patients. Despite the low number of patients, this early study was designed as a controlled prospective study. The trial included seven female patients with a median age of 47.3 years (23–64 years). Only two patients implemented their devices for eight and seven months, respectively. One patient reported a relief in her symptoms, like headaches and pain intensity during the night, by 50% after three month and 80% after six months. Despite the limited number of participants, the study reflects a potential of Intra-aural devices as effective biofeedback devices in treating bruxism.

Management of optic disc pit-associated maculopathy: A case series from a tertiary referral center

2021 ◽  
pp. 112067212110237
Author(s):  
Ilkay Kilic Muftuoglu ◽  
Ecem Onder Tokuc ◽  
V Levent Karabas
Keyword(s):  
Optic Disc ◽  
Case Series ◽  
Internal Limiting Membrane ◽  
Maximum Height ◽  
Optic Disc Pit ◽  
Tertiary Referral Center ◽  
Number Of Patients ◽  
The Mean ◽  
Foveal Center

Purpose: To report outcomes of pars plana vitrectomy (PPV) combined with internal limiting membrane (ILM) stuffing technique in patients with optic disc pit associated maculopathy (ODP-M). Methods: Data including best-corrected visual acuity (BCVA), central macular thickness (CMT), foveal center point thickness (FCP), and maximum height of fluid (max_fluid) (intraretinal or subretinal) were collected from the medical records of the patients. Results: Six eyes of six patients with a mean age of 28.0 ± 17.68 years (range: 9–53 year) underwent PPV + ILM plug surgery. The mean follow-up duration was 25.62 ± 26.11 months (range: 11.80–78.00 month) duration. The mean BCVA increased from 1.25 ± 1.04 logMAR (20/355, Snellen equivalent) to 0.86 ± 1.09 logMAR (20/144, Snellen equivalent) at last follow-up ( p = 0.043). Compared to baseline, CMT, FCP, and max_fluid significantly decreased at all visits after the surgery ( p < 0.05 for all visits). At last follow-up, 66.6% of the eyes (four eyes) showed complete resolution of fluid at a mean of 5.25 ± 4.99 months (range: 1–12 months) after the surgery. Conclusion: PPV with ILM plug seemed to be an effective surgical technique in ODP-M. Studies with longer follow-up and higher number of patients are needed to confirm our results.

scholarly journals Injuries, treatment, and impairment caused by different types of fireworks; results of a 10 year multicenter retrospective cohort study

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Daan T. Van Yperen ◽  
Esther M. M. Van Lieshout ◽  
J. Niels Dijkshoorn ◽  
Cornelis H. Van der Vlies ◽  
Michael H. J. Verhofstad
Keyword(s):  
Surgical Procedures ◽  
Hospital Admissions ◽  
Case Series ◽  
Secondary Outcome ◽  
Number Of Patients ◽  
Whole Person ◽  
Type Of Injury ◽  
Clear Increase ◽  
Level 1 Trauma Center ◽  
Head Neck

Abstract Objectives The primary aim of this study was to evaluate the number of patients reported to a hospital with injuries from consumer fireworks in the months December–January in the past 10 years, and to describe the association between the type of fireworks, injury pattern, treatment, and permanent impairment. Methods A multicenter, retrospective, observational case series. Patients were selected from two hospitals in the Southwest Netherlands: a level 1 trauma center and a specialized burn center. All patients with any fireworks-related injuries treated between December 1 and January 31, during 2007 (December) to 2017 (January), were eligible for participation. The primary outcome was the number of patients with any type of injury caused by fireworks. The secondary outcome measures were patient and injury characteristics, treatment details, and whole person impairment (WPI). The percentage WPI expresses a patient’s degree of permanent impairments as a result of fireworks-related injuries. Results Of the 297 eligible patients, 272 patients were included. From 2007 to 2017, between 21 and 40 patients were treated, and no clear increase or decrease was observed in the number of patients and in the number of patients per type of fireworks. Explosive fireworks mainly caused upper extremity (N = 65; 68%) injuries, while rockets (N = 24; 41%) and aerials (N = 7; 41%) mainly affected the head/neck. Decorative fireworks predominantly resulted in burns (N = 82; 68%), and explosive fireworks in soft tissue lacerations (N = 24; 25%), fractures (N = 16; 17%), and amputations (N = 14; 15%). Patients injured by explosive and homemade fireworks were most often admitted to a hospital (respectively N = 24; 36% and N = 12; 80%), and resulted in the highest proportion undergoing surgical procedures (respectively N = 22; 33% and N = 7; 47%). WPI found in this study was between 0 to 95%, with a median of 0%. In 34 (14%) patients, the injuries resulted in a WPI of ≥1%, mostly as a result of explosive fireworks (N = 18; 53%). Conclusion This study found no increase or decrease in the number of patients treated in two specialized hospitals. Explosive and homemade fireworks could be considered as most dangerous, as they result into the most hospital admissions, surgical procedures, and into the most injuries with permanent impairment as a result.

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