3.Ganglionectomy without Repairing the Bursal Defect: Long-term Results in a Series of 124 Wrist Ganglia.
Antonios DERMON ; Stylianos KAPETANAKIS ; Aliki FISKA ; Kalliopi ALPANTAKI ; Konstantinos KAZAKOS
Clinics in Orthopedic Surgery 2011;3(2):152-156
BACKGROUND: Some surgeons consider the abscission of a part of the articular bursa around the point of the input of ganglion's nape (average 1-2 cm diameter) to be very important with excellent results. However, a literature search revealed disagreement as to whether it is essential to repair a bursa defect. This study examined the effectiveness of this method without repairing the articular defect. An attempt was made to identify the anatomical origin of wrist ganglia during the surgical procedure. METHODS: This study evaluated 124 wrist ganglia that had been treated surgically during 2004-2009 using this technique and without repairing the bursa defect (1-2 cm in diameter). The variables studied were age, gender, time from the occurrence till abscission of the ganglia, former surgical interventions, preoperative and postoperative pain, insertion of the ganglion's nape and complications. Sixty-six patients with a mean follow-up of 42 months and minimum 12 months were examined. RESULTS: At the time of the follow-up, 80.3% had no pain whereas 92.2% showed a remarkable improvement. Seven cases of recurrence (10.6%) were found 2 to 85 months after surgery, of which most appeared during the first year (71.4%). It is important to mention that the majority of the dorsal ganglia (42.8%) originated from the capitate-lunate joint. None of the patients presented with scapholunate or other instability. CONCLUSIONS: This surgical method is a simple and safe with excellent long-term results and a lower recurrence rate compared to other surgical approaches. Overall, repair of the articular bursa is unnecessary.
Adolescent
;
Adult
;
Aged
;
Aged, 80 and over
;
Bursa, Synovial/*surgery
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Female
;
Humans
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Ligaments, Articular/pathology
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Male
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Middle Aged
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Recurrence
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Synovial Cyst/pathology/*surgery
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Wrist/*surgery
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Young Adult
4.Synovial Cyst in the Cervical Region Causing Severe Myelopathy.
Bo Young CHO ; Ho Yeol ZHANG ; Han Sung KIM
Yonsei Medical Journal 2004;45(3):539-542
The authors describe a case of an 80-year-old man with a gradual weakness of the lower extremities not linked to any known traumatic episode over the 2 weeks before admission. CT scan and MRI of the spine revealed a cystic formation, measuring about 1cm in diameter, at C7-T1 at the left posterolateral site at the level of the articular facet. During surgery, the mass appeared to be in the ligamentum flavum at the level of the articular facet and was in contact with the dura mater. After the removal of the mass, there was an immediate and significant improvement of the patient's symptoms. Histopathologic examination showed the cyst to be composed of nonspecific degenerative fibrous tissue with mild inflammatory change and confirmed the cyst as a synovial cyst. Synovial cyst in the cervical region is a very rare lesion causing myelopathy. Surgical removal of the cyst and decompression of the spinal cord results in good neurological recovery.
Aged
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Aged, 80 and over
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Cervical Vertebrae
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Decompression, Surgical
;
Human
;
Magnetic Resonance Imaging
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Male
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Spinal Cord Compression/*etiology/*pathology/surgery
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Synovial Cyst/*complications/*pathology/surgery
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Tomography, X-Ray Computed