Solitary Bone Cyst in the Pedicle of the Lumbar Spine

Kee-Yong Ha; Jae-Hyuk Shin

doi:10.4184/jkss.2001.8.1.86

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Ha and Shin: Solitary Bone Cyst in the Pedicle of the Lumbar Spine

Original Article

Journal of Korean Spine Surg 2001;8(1):86-89.

Published online: 12 February 2001

DOI: https://doi.org/10.4184/jkss.2001.8.1.86

Solitary Bone Cyst in the Pedicle of the Lumbar Spine

Kee-Yong Ha, M.D., Jae-Hyuk Shin, M.D.

Department of Orthopaedic Surgery, Kang-Nam St. Mary's Hospital, The Catholic University of Korea, College of Medicine

Address reprint requests to Kee-Yong Ha, M.D. Department of Orthopaedic Surgery, Kang-Nam St. Mary's Hospital, The Catholic University of Korea, College of Medicine #505, Banpo-dong, Seocho-ku, Seoul, 137-040, Korea Tel : 82-2-590-1464, Fax : 82-2-535-9834, E-mail : kyh@cuk.cmc.ac.kr

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Study Design

A case report and review of the literature.

Objectives

To discuss a solitary bone cyst originating from the pedicle of the first lumbar vertebra.

Summary of Literature Review

The solitary bone cyst in the spinal colume is extremely rare. Since Dawson reported the first case in fourth cervical vertebral body, only 8 cases have been reported. The solitary bone cyst originating in the pedicle of the lumbar vertebra is the first reported case.

Materials and Methods

A 53- year-old female patient visited the emergency room for severe radiating pain to the left lower extremity. T2 weighted MRI image showed a solitary bone cyst in the left pedicle of the first lumbar vertebra.

Results

The medial wall of the pedicle showed cortical breakage causing nerve root compression. Pathology revealed fibrous membrane corresponding to a bone cyst. On postoperative 2 years of follow up, the patient was pain- free enjoying normal daily life.

Conclusion

A case report of a solitary bone cyst in the left pedicle of the first lumbar vertebra accompanied with severe radiating pain resulting from a pathologic fracture and expansion of the medial pedicle wall.

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Keywords: Lumbar, Pedicle, Solitary bone cyst

REFERENCES

1). Aegerter EE and Kirkpatric JA Jr. Orthopedic Diseases. 3rd ed.Philadelphia, WB Saunders Co.: 491;1968.

2). Brodsky AE, Khalil M, and Vandeventer L. Unicameral bone cyst of a lumbar vertebra. J Bone Joint Surg. 68A:1283–1285. 1986.

3). Dawson EG, Mirra JM, Yuhl ET, and Lasser K. So litar y bone cyst of the cervical spine. Clin Orthop. 119:141–143. 1976.

4). Jaffe. HL and Lichtenstein L. Solitary unicameral bone cyst with emphasis on the roentgen picture., the pathologic appearance and the pathogenesis. Arch. Surg. 44:1004–1025. 1942.

5). Lee CC, Wei JD and How SW. Simple bone cyst in cervical vertebral spinous process and laminae: Report of a case. J Formos Med Assoc. 99:54–8. 2000.

6). Matsumoto K, Fuji S, Mochizuki T, and Hukuda S. Solitary bone cyst of a lumbar vertebra. Spine. 15:605–607. 1980.

7). Park CK, Cho KK, Lee SW, Jeon JS, Kang JK, and Choi CR. Simple bone cyst of the axis. Child's Nerv Syst. 13:171–174. 1997.

8). Kent K. Wu and Edwin R. Guise. Unicameral bone cyst of the spine, J Bone Joint Surg. 63A:324–326. 1981.

9). Sawai H, Nemoto F, Kushi M, and Hidaka S. A case report of solitary bone cyst in spinous process of lumbar vertebra. Kanto J Orthop Traumatol. 11:258–261. 1980.

10). Zenmyo M, Komiya S, Hamata T, and Inoue A. A solitary bone cyst in the spinous process of the cervical spine. Spine. 25:641–642. 2000.

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Fig. 1.

Myelogram of the patient showed expansile osteolytic lesion and cortical thinning at the left pedicle of the first lumbar vertebra. No evidence of thecal sac compression is observed.

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Fig. 2-A.

T2 weighted sagital MRI image showed cystic natured cavity at the left pedicle of the first lumbar vertebra. Fig. 2-B. T2 weighted axial MRI image showed the lesion is confined in the pedicle area without invasion into the spinal canal, but the medial wall of the pedicle shows cortical disruption.

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Fig. 3.

Post operative CT image showed the cyst in the pedicle is completely resected including the facet joint.

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Fig. 4.

Pathologic findings showed the lining fibrous membrane corresponding the the cyst wall(HE× 40)

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