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báo cáo hóa học:" Diagnostic challenge: bilateral infected lumbar facet cysts - a rare cause of acute lumbar spinal stenosis and back pain"

Tuyển tập các báo cáo nghiên cứu về hóa học được đăng trên tạp chí sinh học quốc tế đề tài : Diagnostic challenge: bilateral infected lumbar facet cysts - a rare cause of acute lumbar spinal stenosis and back pain | Freedman et al. Journal of Orthopaedic Surgery and Research 2010 5 14 http www.josr-online.eom content 5 1 14 JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH CASE REPORT Open Access Diagnostic challenge bilateral infected lumbar facet cysts - a rare cause of acute lumbar spinal stenosis and back pain Brett A Freedman Tuan L Bui S Timothy Yoon Abstract Symptomatic synovial lumbar facet cysts are a relatively rare cause of radiculopathy and spinal stenosis. This case and brief review of the literature details a patient who presented with acutely symptomatic bilateral spontaneously infected synovial facet L4 5 cysts. This report highlights diagnostic clues for identifying infection of a facet cyst. Introduction Lumbar facet cysts are a less common but well documented cause of compressive radiculopathy and lumbar spinal stenosis with approximately 500 total cases reported in the literature 1-5 . The lumbar facet is a synovial-lined zygoaphophyseal j oint comprising the articulation between the inferior and superior articulating processes of the spinal vertebrae. The facet joint like synovial lined joints of the appendicular skeleton are prone to cyst formation as a manifestation of osteoarthritis. To date infection of a lumbar facet cyst has not been reported in the literature. This case illustrates the clinical findings and outcomes associated with bilateral infected lumbar facet cysts. Case Report History Our patient is a 63 year old overweight gentleman who presented to the emergency room with a three day history of progressive low back pain and pain radiating down the right worse than left leg in an L5 distribution. He also noted an acute onset of drop foot. He rated his pain as 10 out of 10. He reported that he has had a history of intermittent back pain but no prior leg symptoms. He has diabetes which was marginally controlled HgbA1C was 7.4 coronary artery disease and one week prior to presentation he completed an 8 week course of radiation therapy for prostate .