Abstract
The lumbar or sacral root compression is frequently associated with degenerative spinal diseases. It may be caused by the hypertrophic facets, hypertrophic ligamentum flavum, or protruding disc. Canal stenosis, epidural hematoma, the cyst of pseudo-joint from degenerative or lytic-type spondylolisthesis, or tumors are less common. We present one unusual case with the severe progressive symptom of bilateral S2-4 root compression. The 80-year-old active male suffered the intermittent claudication for 4 months and got the worse symptom including bilateral painful buttocks in recent one month. The bilateral radiation pain cannot be changed at any position and taking a rest. Plain x-ray showed the degenerative spondylolisthesis over L4-5 level. The magnetic resonance imaging showed the cyst-like mass indented the dura posteriorly. During the operation, one huge psudo-joint capsule created from the interspinous ligament compressed the dorsal side of the cauda equina. We performed the posterior decompression and removal of the pseudo-joint capsule and ligamentum flavum with posterolateral fusion. The patient was completely resolved from all the symptoms after surgery. Therefore we present the unusual case and discuss the differentiation from synovial or ganglion cysts of the spine.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
