족부와 족관절에서의 신경내 결절종
Intraneural Ganglion Cyst in Foot and Ankle
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Purpose: Pathogenesis of intraneural ganglion is controversial, however, the synovial theory that the intraarticular region is the origination of disease has come into the spotlight nowadays. But there are a few researches about intraneural ganglion in foot and ankle. We studied 7cases of intraneural ganglion. We are going to prove the synovial theory by indentifying articular branch of intraneural ganglion. Materials and Methods: From August 2003 to May 2011, we evaluated 7 ouf of 8 patients diagnosed as a intraneural ganglion in foot and ankle. The gender ratio were 4 male and 3 female, and the mean age at the time of surgery was 52.9 years. Clinically, we checked pre and post operative symptom, muscle tone and whether loss of muscle tone and sensation exists. We analyzed surgical records and preoperative MRI and compared those with intra-operative finding. Results: In MRI analysis of 7cases, the connection around the joints were confirmed, and 1 case was confirmed in the retrospective analysis of MRI. Intraneural ganglions occurred in medial plantar nerve 3 cases, lateral plantar nerve 1 case, superficial peroneal nerve 1 case and sural nerve 1 case. We could not found recurrence during the follow up periods. Most patients relieved pain after operation, but recovery of sensation was unsatisfactory. We could find some cases pathological finding of the nerve intraoperatively, and clinical result of that cases was poor. Conclusion: Intraneural ganglion can occur in various parts in foot and ankle. We concluded that the intranneural ganglion originated from joint by identifying the artichlar branch of ganglion. Due to its small size, it is difficult to find articular branch in operation field. But we do our best to find and remove articular branch. Currently, considering the small amount of research in foot and ankle, more research about articular brach is needed.
Abstract
Purpose: Pathogenesis of intraneural ganglion is controversial, however, the synovial theory that the intraarticular region is the origination of disease has come into the spotlight nowadays. But there are a few researches about intraneural ganglion in foot and ankle. We studied 7cases of intraneural ganglion. We are going to prove the synovial theory by indentifying articular branch of intraneural ganglion. Materials and Methods: From August 2003 to May 2011, we evaluated 7 ouf of 8 patients diagnosed as a intraneural ganglion in foot and ankle. The gender ratio were 4 male and 3 female, and the mean age at the time of surgery was 52.9 years. Clinically, we checked pre and post operative symptom, muscle tone and whether loss of muscle tone and sensation exists. We analyzed surgical records and preoperative MRI and compared those with intra-operative finding. Results: In MRI analysis of 7cases, the connection around the joints were confirmed, and 1 case was confirmed in the retrospective analysis of MRI. Intraneural ganglions occurred in medial plantar nerve 3 cases, lateral plantar nerve 1 case, superficial peroneal nerve 1 case and sural nerve 1 case. We could not found recurrence during the follow up periods. Most patients relieved pain after operation, but recovery of sensation was unsatisfactory. We could find some cases pathological finding of the nerve intraoperatively, and clinical result of that cases was poor. Conclusion: Intraneural ganglion can occur in various parts in foot and ankle. We concluded that the intranneural ganglion originated from joint by identifying the artichlar branch of ganglion. Due to its small size, it is difficult to find articular branch in operation field. But we do our best to find and remove articular branch. Currently, considering the small amount of research in foot and ankle, more research about articular brach is needed.
참고문헌 (30)
- Desy NM, "Ganglion cysts and nerves", Neurosurgery Quarterly, 16, pp.187~194 (2006)
- Rezzouk J, "Nerve compression by mucoid pseudocysts: arguments favoring an articular cause in 23 patients", Rev Chir Orthop Reparatrice Appar Mot, 90, pp.143~146 (2004)
- Coleman SH, "Intraneural ganglion cyst of the peroneal nerve accompanied by complete foot drop. A case report", AM J Sports Med, 29, pp.238~241 (2001)
- Nucci F, "Intraneural synovial cyst of the peroneal nerve: report of two cases and review of the literature", Neurosurgery, 26, pp.339~344 (1990)
- Poppi M, "Intraneural ganglion of the peroneal nerve: an unsual presentation. Case report", Surg Neurol, 31, pp.405~406 (1989)
- Spinner RJ, "Peroneal intraneural ganglia: the importance of the articular branch. A unifying theory", J Neurosurg, 99, pp.330~343 (2003)
- Jacobs RR, "Ganglia of the nerve. Presentation of two unusual cases, a review of the literature, and a discussion of pathogenesis", Clin Orthop Relat Res, 15, pp.135~144 (1975)
- Spinner RJ, "Peroneal intraneural ganglia: the importance of the articular branch. Clinical series", J Neurosurg, 99, pp.319~329 (2003)
- Barrett R, "Tumors of the peripheral nerves and so-called "ganglia" of the peroneal nerve", Clin Orthop Relat Res, 27, pp.135~146 (1963)
- Uretani M, "Peripheral nerve intraneural ganglion cyst: MR findings in three cases", J Comput Assist Tomogr, 22, pp.629~632 (1998)
- Evans JD, "Compression neuropathy of the common peroneal nerve caused by a ganglion", Microsurgery, 15, pp.193~195 (1994)
- Ahn JH, "Intraneural ganglion of the peroneal nerve – a case report", J Korean Orthop Assoc, 7, pp.344~346 (1972)
- Friedlander HL, "Intraneural ganglion of the tibial nerve. A case report", J Bone Joint Surg Am, 49, pp.519~522 (1967)
- 유성호, "후 경골신경과 내측 족저신경 내에 발생한 결절종", 대한정형외과학회지, 43(1), pp.127~130 (2008), 대한정형외과학회
- Suh JT, "Intraneural ganglion of the tibial nerve in the popliteal fossa: a case report", J Korean Knee Soc, 21, pp.109~113 (2009)
- Ledderhose G, "Die Aetiologie der Carpalen Ganglion", Dtsch Zeit Chir, 37, pp.102~ (1893)
- Jensen DR, "Ganglia and synovial cysts: their pathogenesis and trea treatment", Ann Surg, 105, pp.592~601 (1937)
- Brooks DM, "Nerve compression by simple ganglia", J Bone Joint Surg Br, 34-B, pp.391~400 (1952)
- Gazzeri G, "Intraneural synovial cysts of the ex ternal popliteal sciatic nerve. Observations on 2 cases treated with microsurgical technics", Minerva Chir, 39, pp.1143~1145 (1984)
- Mahaley MS Jr, "Ganglion of the posterior tibial nerve. Case report", J Neurosurg, 40, pp.120~124 (1974)
- Robert R, "Intraneural synovial cyst in the peroneal nerve. Case report (author's transl)", Neurochirurgie, 26, pp.135~143 (1980)
- Gurdjian ES, "Intraneural cyst of the peroneal and ulnar nerves. Report of two cases", J Neurosurg, 23, pp.76~78 (1965)
- Champetier J, "Innervation of the tibiotarsal joint (articulatio talocruralis)", Acta Anat, 77, pp.398~421 (1970)
- Lippert H, "Zur Innervation der menschlichen Fussgelenke", Z Anat Entwgesh, 123, pp.295~308 (1962)
- Morin F, "Le enervazioni articolari", pp.138~ (1948), Minerva Medica Torino
- Gardner E, "The Inervation of the joints of the foot", Ana Rec, 161, pp.141~148 (1968)
- Seddon HJ, "Surgical disorders of the peripheral nerves. 1st ed", pp.125~126 (1972), Williams & Wilkins
- Spinner RJ, "The clinic-anantomic explanation for tibial intraneural ganglion cysts arising from the superior tibiofibular joint", Skeletal Radiol, 36, pp.281~292 (2007)
- Spinner RJ, "The use of MR arthrography to document an occult joint communication in a recurrent peroneal intraneural ganglion", Skeletal Radiol, 35, pp.172~179 (2006)
- Spinner RJ, "Recurrent intraneural ganglion cyst of the tibia nerve", J Neurosurg, 92, pp.334~337 (2000)