Acquired Simple Bone Cyst Associated With Lumbar Spinal Canal Stenosis Progression: A Case Report

TL;DR

A rare case of a bone cyst in the lumbar spine is linked to spinal canal stenosis and venous obstruction, improving after surgery.

Contribution

This case report highlights a rare association between an acquired simple bone cyst and lumbar spinal canal stenosis progression.

Findings

A T2-weighted MRI identified a hyperintense lesion in the L5 lamina, later diagnosed as a simple bone cyst.

The cyst was associated with venous infarction and increased venous perfusion due to ligamentum flavum thickening.

Symptoms improved after lumbar decompression surgery, confirming the cyst's role in the patient's condition.

Abstract

A simple bone cyst (SBC) in the posterior lumbar bone structure is very rare. Here, we report a case of SBC at the L5 lumbar lamina with venous obstruction associated with ligamentum flavum thickening. A 59-year-old woman presented with intermittent claudication due to low back pain and bilateral sciatica. A lumbar MRI showed L4-5 lumbar spinal canal stenosis and a T2-weighted image hyperintense lesion in the L5 lamina. Imaging four years earlier showed no lesions in the L5 lamina. Her symptoms improved after lumbar decompression surgery. The L5 lamina lesion was SBC, leading to a diagnosis of venous infarction. The involvement of neovascularization in the mechanism of degenerative hypertrophy in the ligamentum flavum was suggested. In this case, increased venous perfusion and venous obstruction were involved in the formation of the bone cyst.

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