腰椎discal cystの1例

A Case Report of Lumber Discal Cyst

Ⅰ．はじめに

　腰痛や坐骨神経痛を来す疾患として腰椎椎間板ヘルニアは代表的なもので，その診断は臨床症状や所見およびMRIで比較的容易に確定診断に至ることが可能になった．しかし，脊柱管内に発生する嚢胞性病変など椎間板ヘルニアとの鑑別に難渋するものも多い．腰椎discal cystは1997年に戸山らにより提唱された新しい疾患概念で⁹⁾，症状は腰椎椎間板ヘルニアに類似するが，臨床経過や画像所見は特徴的である．しかしながらdiscal cystについてはあまり知られていないのが現状である^1-9)．今回われわれは，腰椎discal cystの1例を経験したので報告する．

　The authors describe a rare case of lumbar discal cyst which produced manifestations similar to lumbar disc herniation. A 33-year-old man, who had had a crick in the back 3 months previously, suffered from severe low back and right lower-extremity pain. The neurological examination showed the L5 radiculopathy through the positive straight leg-raising test, no motor weakness nor sensory disturbance with normal reflexes. Magnetic resonance imaging demonstrated an oval shaped extradural lesion with a low signal intensity on T1-weighted images and a high signal intensity on T2-weighted images. Additionally, the surrounding rim of the cyst was enhanced with the addition of Gd-DTPA. As we diagnosed a lumbar discal cyst with severe symptoms, the patient received emergent surgery. The symptom disappeared immediately after surgery. This case implies that early surgery for discal cyst may be an effective means to obtain release from symptoms.