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Paraparesis as the Presenting Form of a Lumbar Hemorrhagic Synovial CystA Case Report and Review of the Literature
Joana Oliveira, MD1; Pedro Santos Silva, MD1; Paulo Pereira, MD1; Rui Vaz, PhD1
1 Neurosurgery Department, Hospital São João, Alameda Professor Hernâni Monteiro, 4200-319 Porto, Portugal. E-mail address for J. Oliveira: jago79@gmail.com
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Investigation performed at the Neurosurgery Department, Hospital São João, Porto, Portugal

Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. None of the authors, or their institution(s), have had any financial relationship, in the thirty-six months prior to submission of this work, with any entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. Also, no author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Dec 24;3(4):1-5. doi: 10.2106/JBJS.CC.M.00170
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Intraspinal synovial or ganglion cysts are uncommon lesions associated with degenerative lumbosacral spine disease. They have been reported with increasing frequency in part because of the availability of increasingly sensitive imaging studies1. These juxtafacet cysts are usually located in the lumbar spine and mostly present with back pain associated with progressive radiculopathy, or less often with spinal cord compression syndrome2-5. Hemorrhage into these cysts is uncommon but explains acute symptomatology caused by nerve root compression6. To our knowledge, there have been only sixteen cases of hemorrhagic juxtafacet cysts associated with motor deficit reported in the English-language literature2-5,7-17. We report a case in which hemorrhage into an L4-L5 juxtafacet cyst presented as paraparesis; we also describe its successful treatment and review the literature.
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