Full-Endoscopic Resection of Ligamentum Flavum Cyst in Lumbar Spine

Abstract

Background: Cysts of the ligamentum flavum (LF) are rare occurrences, with only a few cases reported in literature. They are a result of age-related degenerative changes in the LF. The cyst compresses the neural elements and causes neurogenic symptoms. Endoscopic resection of the LF cyst has not been described in literature. In this report, we describe our experience with endoscopic resection of an LF cyst in the L3-L4 region.

Case description: A 54-year-old female patient presented with claudication in both lower limbs and evidence on magnetic resonance imaging of a LF cyst in the L3-L4 region compressing the neural elements. The patient underwent full endoscopic resection of the LF cyst through the interlaminar approach from the left side with preservation of facet joints. The postoperative clinical outcomes improved significantly, and postoperative magnetic resonance imaging revealed a complete removal of the cyst.

Conclusions: Full-endoscopic resection may be considered as a viable option for treatment of LF cyst in the lumbar region.

Keywords: Degenerative spine; Endoscopic spine surgery; Interlaminar approach; Ligamentum flavum cyst; Lumbar spine; Minimally invasive spine surgery.