• Po-An Tai and Tin-Chou Li.
• Division of Neurosurgery, Department of Surgery, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City; and Department of Surgery, School of Medicine, Buddhist Tzu Chi University, Hualien County, Taiwan. Electronic address: poan.rita@msa.hinet.net.
• World Neurosurg. 2016 Apr 1; 88: 691.e1-691.e4.

BackgroundLumbar intraspinal ganglion cysts are a rare cause of lumbar radiculopathy. These cysts are often extradural and next to facet joints. Sometimes they are related to ligamentum flavum or posterior longitudinal ligament. To our knowledge, lumbar intradural ganglion cyst has not been reported to date.Case DescriptionWe report a case of a fifth lumbar intradural ganglion cyst in an elderly patient presenting with insidious onset of left-sided lower limb pain. Magnetic resonance imaging of the lumbar spine revealed a left-sided ventrolateral intraspinal cystic lesion abutting on the fifth lumbar vertebral body with ring enhancement of the cyst wall. During surgery, no lesion was found related to the facet joint or in the epidural space. Instead, a dura-based septated ganglion cyst was noted intradurally. The patient's discomfort was completely relieved postoperatively. Follow-up magnetic resonance imaging showed complete removal of the cyst.ConclusionsA lumbar intradural dura-based ganglion cyst in an elderly patient led to compressive radiculopathy. Total removal of the cyst was achieved, and the patient's discomfort was completely relieved after surgery. The origin and pathogenesis of the lumbar intradural ganglion cyst are still unknown. Surgical extirpation is regarded as the treatment of choice.Copyright © 2016 Elsevier Inc. All rights reserved.

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