title: Bilateral discal cysts managed by partial hemilaminectomy and microscopic resection of hemilateral cyst.
abstract: METHODS
  A case report.
  
  
  OBJECTIVE
  The objective of this article was to report a case of bilateral lumbar discal cysts and discuss the clinical, radiological, and surgical findings.
  
  
  BACKGROUND
  Discal cysts are rare lesions and to our knowledge there has been no report on multiple discal cysts at one disc level.
  
  
  METHODS
  The patient's history, clinical examination, imaging findings, and treatment were reported.
  
  
  RESULTS
  We reported on the case of a 33-year-old woman with left lower back and lower extremity pain. Neurological imagings demonstrated bilateral cysts at the L4-L5 disc level. She underwent left partial hemilaminectomy at the L4-L5 level and microscopic resection of the left cyst. The cyst contained bloody serous fluid. A connection between the cyst wall and the L4-L5 intervertebral disc and a small laceration in the annulus fibrosus were identified. Histologic examination revealed a cyst lined by fibrous connective tissue without synovium. Her symptoms improved remarkably immediately after surgery. Follow-up imaging 3 months after the operation showed that the bilateral cysts had completely disappeared.
  
  
  CONCLUSIONS
  This is the first reported case of bilateral discal cysts at one disc level. Magnetic resonance images demonstrated rounded cysts on both sides of the posterior longitudinal ligament, which suggests that the discal cysts in our case were unlikely to have developed from an epidural hematoma. Partial hemilaminectomy and microscopic resection of the left cyst lead to complete regression of the bilateral cysts. This suggests that there was a communication between the two cysts via the intervertebral disc and that the content of the right cyst passed from the cyst to the disc.
authors.affiliation: Spinal Disorders Center, Fujieda Heisei Memorial Hospital, Fujieda, Shizuoka, Japan. sshiba@kuhp.kyoto-u.ac.jp
authors.forename: Sumiya
authors.initials: S
authors.lastname: Shibata
authors.forename: Junya
authors.initials: J
authors.lastname: Hanakita
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Takahashi
authors.forename: Manabu
authors.initials: M
authors.lastname: Minami
authors.forename: Keita
authors.initials: K
authors.lastname: Kuraishi
authors.forename: Mizuki
authors.initials: M
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D003560:Cysts / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007403:Intervertebral Disc / Q000601:surgery*; D007796:Laminectomy / Q000379:methods*; D017116:Low Back Pain / Q000209:etiology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000601:surgery*; D016896:Treatment Outcome