Retrodural Cysts Bridging a Bilateral Lumbar Spondylolysis: A Report of Two Symptomatic Cases

Abstract

We report the MR features in two patients presenting with symptomatic thecal impingement by posterior epidural cysts linking a bilateral lumbar spondylolysis. Large fluid-filled channels bridging the ruptured partes interarticulares were present in spite of the absence of significant arthritic changes within the adjacent facet joints.

The posterior ligamentous complex inflammatory syndrome: spread of fluid and inflammation in the retrodural space of Okada

“…5,18 Several prior reports demonstrate these cysts to be at the level of bilateral spondylolysis. 2,18 In addition to cysts, a prior report describes a pathologically proven fibrotic mass in the posterior spinal canal with associated inflammation and cystic change in the setting of Baastrup disease. 6 Spread of fluid and inflammatory/cystic change throughout the retrodural space of Okada can result in a complex enhancing heterogeneous process in the posterior spinal canal (Fig 4).…”

“…2 The percentage of patients with this imaging pattern who have associated axial low back and/or radicular pain has not been established. Both case series data and the experience of interventional pain physicians are subject to selection bias for patients with pain.…”

“…2 It may also result from direct spread of inflammatory change from the involved facet joint into the neural foramen through the aforementioned known potential communication between these spaces. 3,19 In the authors' experience, axial pain complaints dominate.…”

Resolution of an Intraspinal Cyst Associated With Spondylolysis Causing Radiculopathy in an Adolescent Athlete: A Case Report

“…Although rare, a synovial cyst can develop as a complication of a chronic pars defect. There are only 4 previously reported cases that document symptomatic intraspinal cysts related to chronic spondylolysis [1‐3]. All 4 cases were adults (ages 23‐39 years), all presented with LBP and radicular symptoms, and all were confirmed intraoperatively to have a cyst associated with the pars defect.…”

“…Although degenerative zygapophysial joint synovial cysts are well documented as a potential cause of lumbosacral radiculopathy, only 4 cases of intraspinal cysts from spondylolysis are previously reported [1‐3]. Cyst formation is thought to result from chronic hypermobility of the pars defect creating a pseudoarthosis that uses synovial fluid from adjacent zygapophysial joints as demonstrated in radiologic, surgical, and postmortem anatomical studies [1].…”