Successful Treatment of a Symptomatic Discal Cyst by Percutaneous C-arm Guided Aspiration.
Although discal cysts are a rare cause of low back pain and radiculopathy. Currently, surgical excision is usually the first-line treatment for discal cysts. However, alternative treatment methods have been suggested, as in some cases symptoms have improved with interventional therapies. A 27-year-old man presented with an acute onset of severe pain, and was found to have a discal cyst after an open discectomy. The patient underwent cyst aspiration and steroid injection through the facet joint under C-arm guidance. After the procedure, the patient's pain improved to NRS 0-1. On outpatient physical examination 1 week, and 1 and 3 months later, no abnormal neurological symptoms were present, and pain did not persist; thus, follow-up observation was terminated. When a discal cyst is diagnosed, it is more appropriate to consider interventional management instead of surgery as a first-line treatment, while planning for surgical resection if the symptoms do not improve or accompanying neurologic deficits progress.
Department of Anesthesiology and Pain Medicine, Chungbuk National University Hospital, Cheongju, Korea.
Hyun Jeong
HJ
Yu
Department of Anesthesiology and Pain Medicine, Chungbuk National University Hospital, Cheongju, Korea.
Chan Jin
CJ
Park
Department of Anesthesiology and Pain Medicine, Chungbuk National University Hospital, Cheongju, Korea.
Kyoung Hoon
KH
Yim
Aspiration; Discal cyst; Injection; Intervertebral disc; Lumbar vertebra; Radiculopathy