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Periodontoid Synovial Cyst Causing Cervico-medullary Compression

Published online by Cambridge University Press:  18 September 2015

Anthony M. Kaufmann ,
William C. Halliday ,
Michael West ,
Derek Fewer  and
Ian Ross
Anthony M. Kaufmann*
Affiliation:
Section of Neurosurgery, University of Manitoba
William C. Halliday
Affiliation:
Department of Pathology (WCH), University of Manitoba
Michael West
Affiliation:
Section of Neurosurgery, University of Manitoba
Derek Fewer
Affiliation:
Section of Neurosurgery, University of Manitoba
Ian Ross
Affiliation:
Section of Neurosurgery, University of Manitoba
*
Department of Neurological Surgery, University of Pittsburgh. Suite B-400, 200 Lothrop Street Pittsburgh PA 15213-2582, U.S.A.
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Abstract

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Background: Periodontoid synovial cysts are rare lesions which may produce symptomatic cervico-medullary compression. Method: We report such a patient, whose progressive neurological deterioration required surgical treatment by transoral odontoidectomy and decompression. Results: The diagnostic and theraputic interventions are described, including a lumbar puncture which precipitated a transient loss of consciousness and respiratory arrest. Surgery achieved clinical improvement, without complications or need for operative stablization. Detailed neuropathology is presented, as well as a literature review. Conclusion: Appropriate neuroradiological assessment is required in patients with suspected cervico-medullary compression, and symptomatic periodontoid synovial cysts may respond well to transoral surgical decompression.

Résumé

Résumé

Kyste synovial périodontoïde causant des compressions cervicomédullaires. Introduction: Les kystes synoviaux périodontoïdes sont des lésions rares qui peuvent causer des compressions cervicomédullaires symptomatiques. Méthodes: Nous rapportons le cas d’un patient présentant une détérioration neurologique progressive qui a du être traité chirurgicalement par odontoïdectomie transorale et décompression. Résultats: Nous décrivons les interventions diagnostiques et thérapeutiques, dont la ponction lombaire compliquée d’une perte de conscience transitoire et d’un arrêt respiratoire. La chirurgie a amené une amélioration clinique sans complication et sans stabilisation opératoire. Nous présentons un rapport neuropathologique détaillé ainsi qu’une revue de la littérature. Conclusions: Les patients chez qui on soupçonne une compression cervico-médullaire doivent subir une évaluation neuroradiologique appropriée. La décompression chirurgicale transorale peut donner de bons résultats dans les kystes périodontoïdes symptomatiques.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 23 , Issue 3 , August 1996 , pp. 227 - 230
Copyright
Copyright © Canadian Neurological Sciences Federation 1996

References

1. Goffin, J., Wilms, G., Plets, C., Bruneel, B., Casselman, J. Synovial cyst at the CI-C2 junction. Neurosurgery 1992; 20(6): 914–916.Google Scholar
2. Miller, JD., Al-Mefty, O., Middleton, TH. Synovial cyst at the craniovertebral junction. Surg Neurol 1989; 31: 239–242.Google Scholar
3. Onofrio, BM., Mih, AD. Synovial cysts of the spine. Neurosurgery 1988; 22(4): 642–647.Google Scholar
4. Crockard, HA., Heilman, AE., Stevens, JM. Progressive myelopathy secondary to odontoid fractures: clinical, radiological, and surgical features. J Neurosurgery 1993; 78: 579–586.Google Scholar
5. Elsberg, CA., Strauss, I. Tumors of the spinal cord which project into the posterior cranial fossa. Report of a case in which a growth was removed from the ventral and lateral aspects of the medulla oblongata and upper cervical cord. Arch Neurol Psychiatr 1929; 21: 261–273.Google Scholar
6. Symonds, CP., Meadows, SP. Compression of the spinal cord in the neighborhood of the foramen magnum. Brain 1937: 60: 52–84.Google Scholar
7. Bhushan, C., Hodges, FJ. III, Wityk, JJ. Synovial cysts (ganglion) of the lumbar spine simulating extradural mass. Neuroradiology 1979: 18: 263–8.Google Scholar
8. Brish, A., Payan, HM. Lumbar intraspinal extradural ganglion cyst. J Neurol Neurosurg Psychatry 1972; 35: 771–4.Google Scholar
9. Cartwright, MJ., Nehls, DF., Carrion, GC., Spetzler, RF. Synovial cyst of a cervical facet joint: case report. Neurosurgery 1985; 16: 850–2.CrossRefGoogle ScholarPubMed
10. Chen, KTK. Synovial cyst of the spinal facet joint. Arch Pathol Lab Med 1983; 107: 100–1.Google Scholar
11. Jabre, A., Shahbabian, S., Keller, J. Synovial cyst of the cervical spine. Neurosurgery 1987; 20: 316–8.Google Scholar
12. Kao, CC., Uihlein, A., Bickel, WH., Soule, EH. Lumbar intraspinal extradural ganglion cyst. J Neurosurg 1968; 29: 168–72.Google Scholar
13. Kao, CC., Winkler, SS., Turner, JH. Synovial cyst of the spinal facet. Case report. J Neurosurg 1974; 41: 372–6.Google Scholar
14. Nijensohn, E., Russell, EJ., Milan, M., Brown, T. Calcified synovial cyst of the cervical spine: CT and MR evaluation. J Comput Assist Tomogr 1990; 14: 473–6.Google Scholar
15. Patel, SC., Sanders, WP. Synovial cyst of the cervical spine. Case report and review of the literature. Am J Neuroradiol 1988; 9: 602–3.Google Scholar
16. Abdullah, AF., Chambers, RW., Daut, DP. Lumbar nerve root compression by synovial cysts of the ligaments flavum. Report of four cases. J Neurosurg 1984; 60: 617: 20.Google Scholar
17. Haase, J. Extradural cyst of ligamentum flavum L4 – a case. Acta Orthop Scand 1972; 43: 32–38.Google Scholar
18. Moiel, RH., Ehni, G., Anderson, MS. Nodule of the ligamentum flavum as a cause of nerve root compression. Case report. J Neurosurg 1967; 27: 456–8.Google Scholar
19. Casuccio, C., Scapinelli, R. Clinical and anatomico-radiological studies of pathological changes in the vertebral spinous processes and adjacent soft tissue. J Bone Joint Surg 1962; 44B: 218.Google Scholar
20. Alquacil-Garcia, A. Spinal synovial cyst (ganglion). Review and report of a case presenting as a retropharyngeal mass. Am J Surg Pathol 1987; 11(9): 723–735.Google Scholar
21. Aegerter, E., Kirkpatrick, JA. Orthopedic Disease: Physiology, Pathology, Radiology. 4th ed. Philadelphia: WB Saunders, 1975; 763–4.Google Scholar
22. Silverberg, R. Diseases of the joints. In: Anderson, WAD., Kissane, JM., eds. Pathology, Vol 7th ed. St. Louis: CV Mosby, 1977; 2041.Google Scholar
23. Herrington, JL Jr, Edwards, LW. Ganglion cysts arising in unusual locations. Ann Surg 1955; 142: 900–3.Google Scholar
24. Kurz, LT., Garfin, SR., Unger, AS., Thome, RP., Rothman, RH. Intraspinals synovial cyst causing sciatica. J Bone Joint Surg [Am] 1985; 67A: 865–71.Google Scholar
25. Maresca, L., Meland, NB., Maresca, C., Field, EM. Ganglion cyst of the spinal canal: case report. J Neurosurg 1982; 57: 140–2.Google Scholar
26. Pendleton, B., Carl, B., Pollay, M. Spinal extradural benign synovial or ganglion cyst: case report and review of the literature. Neurosurgery 1983; 13(3): 322–6.Google Scholar
27. Crockard, HA., Sett, P., Geddes, JF., Stevens, JM., Kendall, BE., Pringle, JAS. Damaged ligaments at the craniocervical junction presenting as an extradural tumor: a differential diagnosis in the elderly. J Neurol Neurosurg Psychiatry 1991; 54: 817–821.Google Scholar
28. Sze, F., Brant-Zawadzki, MN., Wilson, CR., Norman, D., Newton, TH. Pseudotumor of the craniovertebral junction associated with chronic subluxation: MR imaging studies. Radiology 1986; 161: 391–4.CrossRefGoogle ScholarPubMed
29. Crockard, HA. The transoral approach to the base of the brain and upper cervical cord. Ann R Coll Surg Engl 1985; 67: 321–325.Google Scholar
30. Dickman, CA., Locantro, J., Fessler, RG. The influence of transoral odontoid resection on stability of the craniovertebral junction. J Neurosurg 1992; 77: 525–30.Google Scholar