Pigmented villonodular synovitis originating from the lumbar facet joint: a case report.
The authors successfully treated a rare case of pigmented villonodular synovitis (PVNS) that originated from the lumbar facet joint (L4-5). A 43-year-old man presented with a complaint of left severe sciatica causing difficulty in walking. Magnetic resonance imaging (MRI) demonstrated an extradural mass on the left side at L4 and the mass compressed the dural tube and was continuous with the left L4-5 facet joint. A computed tomography myelogram revealed an extradural defect of contrast medium at the L4 level and an erosion of the L4 lamina. A total synovectomy with unilateral osteoplastic laminectomy was performed. The histological findings were a diagnosis of PVNS. The patient's symptoms resolved completely and the MRI at postoperative 3 years demonstrated no recurrence of PVNS. It is important to totally remove the synovium, which is the origin of PVNS in order to prevent the recurrence. We think that our procedure is reasonable and adequate for lumbar PVNS.
Oe
Kenichi
K
Department of Orthopaedic Surgery, Kansai Medical University, 2-3-1 Shinmachi, Hirakata City, Osaka, 573-1191, Japan.
Sasai
Kunihiko
K
Yoshida
Yugo
Y
Ohnari
Hiroyuki
H
Iida
Hirokazu
H
Sakaida
Noriko
N
Uemura
Yoshiko
Y
D000328:Adult; D019299:Decompression, Surgical; D004388:Dura Mater / Q000000981:diagnostic imaging / Q000293:injuries / Q000473:pathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D009192:Myelography; D019635:Neurosurgical Procedures; D011128:Polyradiculopathy / Q000209:etiology / Q000473:pathology / Q000503:physiopathology; D012585:Sciatica / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D055502:Secondary Prevention; D013115:Spinal Canal / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D013126:Spinal Nerve Roots / Q000293:injuries / Q000473:pathology / Q000503:physiopathology; D013586:Synovitis, Pigmented Villonodular / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000473:pathology* / Q000601:surgery