A Ventral Epidural Facet Cyst Causing Central Canal Stenosis and Lumbar Nerve Compression in a Woman With Lumbar Radicular Pain

摘要

A 49-year-old woman presented with 6 weeks gradual onset low back pain radiating into both legs without inciting trauma. Her symptoms worsened with weight-bearing activity and were relieved with sitting. Her history was otherwise unremarkable, and the findings of her examination were notable only for positive dural tension signs. A radiograph of the lumbar spine revealed facet arthropathy at L5-S1 (Figure 1). Initial lumbar magnetic resonance imaging without contrast was obtained and revealed severe L4-5 facet arthrosis; a high T2-weighted, multilocular lesion in the ventral epidural space at L4-5 creating moderate-to-severe central spinal canal narrowing; and right L5 nerve compression within the right lateral recess (Figures 2 and 3).