This article presents a narrative review of cystic lesions around the hip and primarily consists of 5 sections:Radiological examination, prevalence, pathogenesis, symptoms, and treatment. Cystic lesions around the hip...This article presents a narrative review of cystic lesions around the hip and primarily consists of 5 sections:Radiological examination, prevalence, pathogenesis, symptoms, and treatment. Cystic lesions around the hip are usually asymptomatic but may be observed incidentally on imaging examinations, such as computed tomography and magnetic resonance imaging. Some cysts may enlarge because of various pathological factors, such as trauma, osteoarthritis, rheumatoid arthritis, or total hip arthroplasty(THA), and may become symptomatic because of compression of surrounding structures, including the femoral, obturator, or sciatic nerves, external iliac or common femoral artery, femoral or external iliac vein, sigmoid colon, cecum, small bowel, ureters, and bladder. Treatment for symptomatic cystic lesions around the hip joint includes rest, nonsteroidal anti-inflammatory drug administration, needle aspiration, and surgical excision. Furthermore, when these cysts are associated with osteoarthritis, rheumatoid arthritis, and THA, primary or revision THA surgery will be necessary concurrent with cyst excision. Knowledge of the characteristic clinical appearance of cystic masses around the hip will be useful for determining specific diagnoses and treatments.展开更多
目的探讨关节镜下切除腘窝囊肿的手术方法与疗效。方法自2013年1月至2014年2月我科采用关节镜下切除25例腘窝囊肿,腘窝囊肿均为单膝,左膝13例、右膝12例。其中,男10例,女15例,年龄为40~65岁。术前常规体检、患膝X线和MRI检查,观察膝关...目的探讨关节镜下切除腘窝囊肿的手术方法与疗效。方法自2013年1月至2014年2月我科采用关节镜下切除25例腘窝囊肿,腘窝囊肿均为单膝,左膝13例、右膝12例。其中,男10例,女15例,年龄为40~65岁。术前常规体检、患膝X线和MRI检查,观察膝关节骨与软组织的病变。膝关节镜手术常规采用前内、前外侧入路,术中常规探查并清理膝关节内病变。评价病人并发症、疼痛、复发情况,采用Lysholm膝关节评分、美国膝关节协会评分(knee society score,KSS)、美国特种外科医院(Hospital for Special Surgery,HSS)评分比较病人术前术后的情况。结果 25例病人均获得随访,随访时间为6~12个月,平均为(9.0±1.9)个月。复查MRI发现1例类风湿性膝关节炎病人腘窝囊肿复发,但无明显临床症状。术前Lysholm膝关节评分为(48.76±12.07)分,术后术后末次随访为(81.72±7.57)分;术前KSS为(52.32±11.16)分,术后末次随访为(85.84±6.85)分;术前HSS评分为(55.62±10.76)分,术后末次随访为(88.64±6.24)分。3个指标术后与术前比较,差异均有统计学意义(均P<0.05)。结论关节镜下打开内侧关节囊与腘窝囊肿之间的"阀门"并切除囊壁,可以达到治疗腘窝囊肿的目的。本研究手术方法简单有效、安全性高,并可同时处理腘窝囊肿的诱发因素,有效地降低囊肿的复发率。展开更多
AIM To analyze different terms used in literature to identify lumbar extradural cysts and propose a common scientific terminology; to elaborate a new morphological classification of this pathology, useful for clinical...AIM To analyze different terms used in literature to identify lumbar extradural cysts and propose a common scientific terminology; to elaborate a new morphological classification of this pathology, useful for clinical and surgical purposes; and to describe the best surgical approach to remove these cysts, in order to avoid iatrogenic instability or treat the pre-existing one. METHODS We retrospectively reviewed 34 patients with symptomatic lumbar ganglion cysts treated with spinal canal decompression with or without spinal fixation. Microsurgical approach was the main procedure and spinal instrumentation was required only in case of evident preoperative segmental instability. RESULTS The complete cystectomy with histological examination was performed in all cases. All patients presented an improvement of clinical conditions, evaluated by Visual Analogic Scale and Japanese Orthopaedic Association scoring. CONCLUSION Spinal ganglion cysts are generally found in the lumbar spine. The treatment of choice is the microsurgical cystectomy, which generally does not require stabilization.The need for fusion must be carefully evaluated: Preoperative spondylolisthesis or a wide joint resection, during the operation, are the main indications for spinal instrumentation. We propose the terms "ganglion cyst" to finally identify this spinal pathology and for the first time its morphological classification, clinically useful for all specialists.展开更多
文摘This article presents a narrative review of cystic lesions around the hip and primarily consists of 5 sections:Radiological examination, prevalence, pathogenesis, symptoms, and treatment. Cystic lesions around the hip are usually asymptomatic but may be observed incidentally on imaging examinations, such as computed tomography and magnetic resonance imaging. Some cysts may enlarge because of various pathological factors, such as trauma, osteoarthritis, rheumatoid arthritis, or total hip arthroplasty(THA), and may become symptomatic because of compression of surrounding structures, including the femoral, obturator, or sciatic nerves, external iliac or common femoral artery, femoral or external iliac vein, sigmoid colon, cecum, small bowel, ureters, and bladder. Treatment for symptomatic cystic lesions around the hip joint includes rest, nonsteroidal anti-inflammatory drug administration, needle aspiration, and surgical excision. Furthermore, when these cysts are associated with osteoarthritis, rheumatoid arthritis, and THA, primary or revision THA surgery will be necessary concurrent with cyst excision. Knowledge of the characteristic clinical appearance of cystic masses around the hip will be useful for determining specific diagnoses and treatments.
文摘目的探讨关节镜下切除腘窝囊肿的手术方法与疗效。方法自2013年1月至2014年2月我科采用关节镜下切除25例腘窝囊肿,腘窝囊肿均为单膝,左膝13例、右膝12例。其中,男10例,女15例,年龄为40~65岁。术前常规体检、患膝X线和MRI检查,观察膝关节骨与软组织的病变。膝关节镜手术常规采用前内、前外侧入路,术中常规探查并清理膝关节内病变。评价病人并发症、疼痛、复发情况,采用Lysholm膝关节评分、美国膝关节协会评分(knee society score,KSS)、美国特种外科医院(Hospital for Special Surgery,HSS)评分比较病人术前术后的情况。结果 25例病人均获得随访,随访时间为6~12个月,平均为(9.0±1.9)个月。复查MRI发现1例类风湿性膝关节炎病人腘窝囊肿复发,但无明显临床症状。术前Lysholm膝关节评分为(48.76±12.07)分,术后术后末次随访为(81.72±7.57)分;术前KSS为(52.32±11.16)分,术后末次随访为(85.84±6.85)分;术前HSS评分为(55.62±10.76)分,术后末次随访为(88.64±6.24)分。3个指标术后与术前比较,差异均有统计学意义(均P<0.05)。结论关节镜下打开内侧关节囊与腘窝囊肿之间的"阀门"并切除囊壁,可以达到治疗腘窝囊肿的目的。本研究手术方法简单有效、安全性高,并可同时处理腘窝囊肿的诱发因素,有效地降低囊肿的复发率。
文摘AIM To analyze different terms used in literature to identify lumbar extradural cysts and propose a common scientific terminology; to elaborate a new morphological classification of this pathology, useful for clinical and surgical purposes; and to describe the best surgical approach to remove these cysts, in order to avoid iatrogenic instability or treat the pre-existing one. METHODS We retrospectively reviewed 34 patients with symptomatic lumbar ganglion cysts treated with spinal canal decompression with or without spinal fixation. Microsurgical approach was the main procedure and spinal instrumentation was required only in case of evident preoperative segmental instability. RESULTS The complete cystectomy with histological examination was performed in all cases. All patients presented an improvement of clinical conditions, evaluated by Visual Analogic Scale and Japanese Orthopaedic Association scoring. CONCLUSION Spinal ganglion cysts are generally found in the lumbar spine. The treatment of choice is the microsurgical cystectomy, which generally does not require stabilization.The need for fusion must be carefully evaluated: Preoperative spondylolisthesis or a wide joint resection, during the operation, are the main indications for spinal instrumentation. We propose the terms "ganglion cyst" to finally identify this spinal pathology and for the first time its morphological classification, clinically useful for all specialists.
