J Korean Soc Spine Surg.  2001 Mar;8(1):86-89.

Solitary Bone Cyst in the Pedicle of the Lumbar Spine

• Ha KY
• Shin JH

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.

Keyword

Lumbar; Pedicle; Solitary bone cyst

MeSH Terms

Bone Cysts*
Emergency Service, Hospital
Female
Follow-Up Studies
Fractures, Spontaneous
Humans
Lower Extremity
Magnetic Resonance Imaging
Membranes
Middle Aged
Pathology
Radiculopathy
Spine*

Figure

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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)

Reference

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