Variant of a Lumbar Disc Cyst in a 13-Year-Old Girl: A Case Report

Abstract

A disc cyst is a rare entity with a clinical presentation that closely mimics an intervertebral disc herniation. Disc cysts are ventrally located, intraspinal, extradural cystic lesions that communicate with the parent intervertebral disc through a ruptured annulus. We present the clinical features, magnetic resonance imaging, intra-operative and histopathological findings of a variant of a lumbar intervertebral disc cyst in a 13-year-old girl who presented with a 6-month history of unilateral radiculopathy following an injury. Magnetic resonance imaging revealed a large posterocentral, fluid-filled cyst occupying the L5-S1 interspace and bulging into the spinal canal. The cyst was confined within an intact bulging annulus fibrosis and extended directly from the parent disc. The cyst was surgically decompressed, resulting in complete symptomatic relief.

Ventral Intraspinal Cysts Associated with the Intervertebral Disc: Magnetic Resonance Imaging Observations in Seven Dogs

“…Despite the suggested communication of cysts with intervertebral discs, and theories for cyst development, all of which originate with a degenerated or herniated disc, none of the human reports document discal material within the cyst, 1–6 in contrast to our finding in one cyst. This may reflect different pathologies or different stages of the same pathology, or perhaps differences in biomechanical properties and/or genesis of discal cysts in dogs compared with humans.…”

“…Whereas the number of reported human cases of discal cyst have increased recently, all have been in the lumbar spine, 1–6 whereas our dogs were more commonly affected in the lower cervical spine. One can speculate that differences in biomechanics and/or nutrition of the intervertebral discs in dogs compared with humans may explain the cervical location in dogs.…”

“…DISCAL CYSTS, reported in the human lumbar spine, 1–6 communicate with the intervertebral disc, are surrounded by a thin, contrast enhancing capsule and contain serous or serosanguinous fluid. These cysts cause similar symptoms to disc herniation and are diagnosed by magnetic resonance imaging (MRI), computed tomography (CT), discography, or a combination of these methods.…”

Lumbar discal cyst causing bilateral radiculopathy

“…However, in three cases, including ours, cysts that crossed the midline were reported. [710] A median septum, connects ventrally with the thickened periosteum and dorsally with the PLL. However, it is not present in the intervertebral disc space in which the PLL is strongly attached to the annulus fibrosus.…”

Discal Cyst in Pediatric Patients: Case Report and Review of the Literature

“…Discal cyst is a rare fluid-filled intraspinal extradural cystic lesion that communicates with intervertebral disk. It is a rare cause of low back pain and radiculopathy, [1][2][3][4][5][6][7][8] particularly in pediatric patients. We present a 15-year-old boy with discal cyst arising from the L5-S1 disk causing acute right-side S1 radiculopathy.…”