Цервикалгия и цервикобрахиалгия при периартикулярной кисте на шейном уровне

Керимова Е.К., Исайкин А.И., Романова А.С., Башлачев М.Г., Кинан Муки. Цервикалгия и цервикобрахиалгия при периартикулярной кисте на шейном уровне. Consilium Medicum. 2025;27(2):94–98. DOI: 10.26442/20751753.2025.2.203154

© ООО «КОНСИЛИУМ МЕДИКУМ», 2025 г.

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Kerimova EK, Isaikin AI, Romanova AS, Bashlachev MG, Mouki Kinan. Cervicalgia and cervicobrachialgia in periarticular cyst at the cervical level. Case report. Consilium Medicum. 2025;27(2):94–98. DOI: 10.26442/20751753.2025.2.203154

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Аннотация

Периартикулярные кисты (ПАК) на уровне шейного отдела позвоночника встречаются редко и вызывают сложности в диагностике. Представлен клинический случай пациентки 72 лет со стенозом позвоночного канала на уровне С7-Th-1 вследствие ПАК на уровне С7-Th1 справа и компрессионно-ишемической радикулопатией С8 справа. В течение 10 мес не определена причина радикулопатии на шейном уровне, не отмечен эффект от лечения. Пациентке назначены повторные курсы терапии лекарственными препаратами, физиотерапевтического лечения, массажа, лечебно-диагностических инъекций и блокад, при этом не рассматривалась возможность ПАК, при которой наиболее эффективно хирургическое лечение. Выявление ПАК, ее хирургическое лечение с последующей кинезиотерапией привели к полному регрессу болевого синдрома в течение 3 мес. Обсуждаются вопросы патогенеза, диагностики и лечения ПАК шейного отдела позвоночника.

Ключевые слова: хроническая боль в шейном отделе позвоночника, хирургическое лечение, мультидисциплинарный подход

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Periarticular cysts (PAC) at the level of the cervical spine are rare and cause difficulties in diagnosis. The article presents an observation of a 72-year-old patient with spinal canal stenosis at the C7-Th1 level due to a PAC at the C7-Th1 level on the right, compression-ischemic radiculopathy C8 on the right. For 10 months, the cause of radiculopathy at the cervical level was not determined, and there was no effect from the treatment. The patient was prescribed repeated courses of drug treatment, physiotherapy, massage, diagnostic injections and blockages, while not considering the possibility of a PAC in which surgical treatment is most effective. The detection of a PAC, its surgical treatment, followed by kinesiotherapy led to a complete regression of pain syndrome within 3 months. The issues of pathogenesis, diagnosis and treatment of PAC of the cervical spine are discussed.

Keywords: chronic pain in the cervical spine, surgical treatment, multidisciplinary approach

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Список литературы

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26. Исайкин А.И, Шмидт Т.Е, Шор Ю.М. Цервикальная радикулопатия. Неврология, нейропсихиатрия, психосоматика. 2022;14(5):103-8 [Isaikin AI, Schmidt TE, Shor YuM. Cervical radiculopathy. Nevrologiya, neyropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2022;14(5):103-8 (in Russian)]. DOI:10.14412/2074-2711-2022-5-103-108
27. Rosenstock T, Vajkoczy P. New classification of facet joint synovial cysts. Acta Neurochir (Wien). 2020;162(4):929-36. DOI:10.1007/s00701-020-04264-2
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32. Themistoklis KM, Papasilekas TI, Boviatsis KA, et al. Spinal synovial cysts. A case series and current treatment options. J Clin Neurosci. 2018;57:173-7. DOI:10.1016/j.jocn.2018.08.038
33. Masuda R, Ajimi J, Murata T. Pharmacotherapy for Neuropathic Pain in Japan. J Nippon Med Sch. 2017;84(6):258-67. DOI:10.1272/jnms.84.258
34. Alshami AM, Bamhair DA. Effect of manual therapy with exercise in patients with chronic cervical radiculopathy: a randomized clinical trial. Trials. 2021;22(1):716. DOI:10.1186/s13063-021-05690-y
35. Wibault J, Öberg B, Dedering A, et al. Structured postoperative physiotherapy in patients with cervical radiculopathy: 6-month outcomes of a randomized clinical trial. J Neurosurg Spine. 2018;28(1):1-9. DOI:10.3171/2017.5.SPINE16736
36. Peolsson A, Löfgren H, Dedering Å, et al. Postoperative structured rehabilitation in patients undergoing surgery for cervical radiculopathy: a 2-year follow-up of a randomized controlled trial. J Neurosurg Spine. 2019;31(1):60-9. DOI:10.3171/2018.12.SPINE181258
37. Meziat-Filho N, Lima M, Fernandez J, Reis FJJ. Cognitive Functional Therapy (CFT) for chronic non-specific neck pain. J Bodyw Mov Ther. 2018;22(1):32-6. DOI:10.1016/j.jbmt.2017.03.010
38. Rundell SD, Davenport TE. Patient education based on principles of cognitive behavioral therapy for a patient with persistent low back pain: a case report. J Orthop Sports Phys Ther. 2010;40(8):494-501. DOI:10.2519/jospt.2010.3264
39. Zilliox LA. Neuropathic Pain. Continuum (Minneap Minn). 2017;23(2, Selected Topics in Outpatient Neurology):512-32. DOI:10.1212/CON.0000000000000462
40. Arnstein P. Chronic neuropathic pain: issues in patient education. Pain Management Nursing. 2004;5:34-41. DOI:10.1016/j.pmn.2004.10.003
41. Shin JC, Kim NY, Chang SH, et al. Effect of Patient Education on Reducing Medication in Spinal Cord Injury Patients With Neuropathic Pain. Ann Rehabil Med. 2017;41(4):621-30. DOI:10.5535/arm.2017.41.4.621

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1. Boviatsis EJ, Stavrinou LC, Kouyialis AT, et al. Spinal synovial cysts: pathogenesis, diagnosis and surgical treatment in a series of seven cases and literature review. Eur Spine J. 2008;17(6):831-7. DOI:10.1007/s00586-007-0563-z
2. Lyons MK, Birch BD, Krauss WE, et al. Subaxial cervical synovial cysts: report of 35 histologically confirmed surgically treated cases and review of the literature. Spine (Phila Pa 1976). 2011;36(20):E1285-9. DOI:10.1097/BRS.0b013e31820709a8
3. Métellus P, Fuentes S, Adetchessi T, et al. Retrospective study of 77 patients harbouring lumbar synovial cysts: functional and neurological outcome. Acta Neurochir (Wien). 2006;148(1):47-54; discussion 54. DOI:10.1007/s00701-005-0650-z
4. Isaikin AI. Neck pain: causes, diagnosis, treatment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2011;3(4):94-8 (in Russian). DOI:10.14412/2074-2711-2011-354
5. Parfenov VA, Lamkova IA. Chronic musculoskeletal low back pain: comorbid disorders and therapy. Meditsinskiy sovet = Medical Council. 2021;(10):34-41 (in Russian). DOI:10.21518/2079-701X-2021-10-34-41
6. Chechet EA, Parfenov VA. Management of patients with neck pain. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2016;8(1):4-8 (in Russian). DOI:10.14412/2074-2711-2016-1-4-8
7. Choi HS, Lee YJ, Hahm DH, et al. The effect of integrative Korean medicine treatment on symptomatic lumbar facet joint cysts: A case series. Explore (NY). 2024;20(1):130-3. DOI:10.1016/j.explore.2023.06.003
8. Chun YM, Boudier-Revéret M, Lee SH, Chang MC. Neuropathic pain due to compression of cervical medial branch by cervical Juxtafacet cyst: A case report. Pain Pract. 2022;22(7):662-6. DOI:10.1111/papr.13129
9. Krauss WE, Atkinson JL, Miller GM. Juxtafacet Cysts of the Cervical Spine. Neurosurgery. 2011;43(6):1363-38. DOI:10.1227/00006123-199812000-00058
10. Pikis S, Cohen JE, Barzilay Y, et al. Symptomatic facet cysts of the subaxial cervical spine. J Clin Neurosci. 2013;20(7):928-32. DOI:10.1016/j.jocn.2012.10.018
11. Spinner RJ, Hébert-Blouin MN, Maus TP, et al. Evidence that atypical juxtafacet cysts are joint derived. J Neurosurg Spine. 2010;12(1):96-102. DOI:10.3171/2009.7.SPINE09257
12. Bashir EF, Ajani O. Management of Lumbar Spine Juxtafacet Cysts. World Neurosurgery. 2012;77(1):141-4. DOI:10.1016/j.wneu.2011.06.034
13. Mak D, Vidoni A, James S, et al. Magnetic Resonance Imaging Features of Cervical Spine Intraspinal Extradural Synovial Cysts. Can Assoc Radiol J. 2019;70(4):403-0. DOI:10.1016/j.carj.2018.12.005
14. Hatem O, Bedou G, Négre C, et al. Intraspinal cervical degenerative cyst. Report of three cases. J Neurosurg. 2001;95(Suppl. 1):139-42. DOI:10.3171/spi.2001.95.1.0139
15. Deshmukh NV, Kanse P. Lumbar facet synovial cyst. Postgraduate Medical Journal. 2003;79(933):419-1. DOI:10.1136/pmj.79.933.419
16. Ulus A, Altun A, Senel A. Lumbar Juxtafacet Cysts. Turk Neurosurg. 2020;30(3):416-21. DOI:10.5137/1019-5149.JTN.27588-19.2
17. Xu R, McGirt MJ, Parker SL, et al. Factors associated with recurrent back pain and cyst recurrence after surgical resection of one hundred ninety-five spinal synovial cysts: analysis of one hundred sixty-seven consecutive cases. Spine (Phila Pa 1976). 2010;35(10):1044-53. DOI:10.1097/BRS.0b013e3181bdafed
18. Kasliwal M, Deutsch H. Completely calcified lumbar synovial cyst. Neurol India. 2011;59(2):315. DOI:10.4103/0028-3886.79173
19. Downs E, Marshman LAG. Spontaneous Resolution of Lumbar Facet Joint Cyst. World Neurosurg. 2018;115:414-1. DOI:10.1016/j.wneu.2018.04.197
20. Sarica C, Kucuk F. Contralateral Recurrence of a Lumbar Juxtafacet Cyst Following Spontaneous Resolution. J Coll Physicians Surg Pak. 2022;32(4):S85-8. DOI:10.29271/jcpsp.2022.Supp1.S85
21. Mattei TA, Goulart CR, McCall TD. Pathophysiology of regression of synovial cysts of the lumbar spine: the anti-inflammatory hypothesis. Med Hypotheses. 2012;79(6):813-8. DOI:10.1016/j.mehy.2012.08.034
22. Kostanian V, Mathews M. CT Guided Aspiration of a Cervical Synovial Cyst. Interv Neuroradiol. 2017;13(3):295-9. DOI:10.1177/159101990701300310
23. Lunardi P, Acqui M, Ricci G, et al. Cervical synovial cysts: case report and review of the literature. Eur Spine J. 1999;8(3):232-7. DOI:10.1007/s005860050164
24. Isaikin AI, Nasonova TI. Muscular factor in the development of musculoskeletal pain. Treatment options. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2022;14(2):98-104 (in Russian). DOI:10.14412/2074-2711-2022-2-98-104
25. Kalinin AA, Okoneshnikova AK, Byvaltsev VA. Treatment of patients with degenerative diseases of the lumbosacral spine using a new method of facet stabilization with an implant Facet Wedge. Sovremennye tekhnologii v meditsine. 2017;9(2):131-40 (in Russian). DOI:10.17691/stm2017.9.2.16
26. Isaikin AI, Schmidt TE, Shor YuM. Cervical radiculopathy. Nevrologiya, neyropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2022;14(5):103-8 (in Russian). DOI:10.14412/2074-2711-2022-5-103-108
27. Rosenstock T, Vajkoczy P. New classification of facet joint synovial cysts. Acta Neurochir (Wien). 2020;162(4):929-36. DOI:10.1007/s00701-020-04264-2
28. Lim AK, Higgins SJ, Saifuddin A, Lehovsky J. Symptomatic lumbar synovial cyst: management with direct CT-guided puncture and steroid injection. Clin Radiol. 2001;56(12):990-3. DOI:10.1053/crad.2001.0710
29. Boissière L, Valour F, Rigal J, Soderlund C. Lumbar synovial cyst calcification after facet joint steroid injection. BMJ Case Rep. 2013;2013. DOI:10.1136/bcr-2012-008029
30. Found E, Bewyer D. Cervical synovial cyst: case report. Iowa Orthop J. 2011;31:215-8.
31. Machino M, Yukawa Y, Ito K, Kato F. Cervical degenerative intraspinal cyst: a case report and literature review involving 132 cases. BMJ Case Rep. 2012;2012:bcr2012007126. DOI:10.1136/bcr-2012-007126
32. Themistoklis KM, Papasilekas TI, Boviatsis KA, et al. Spinal synovial cysts. A case series and current treatment options. J Clin Neurosci. 2018;57:173-7. DOI:10.1016/j.jocn.2018.08.038
33. Masuda R, Ajimi J, Murata T. Pharmacotherapy for Neuropathic Pain in Japan. J Nippon Med Sch. 2017;84(6):258-67. DOI:10.1272/jnms.84.258
34. Alshami AM, Bamhair DA. Effect of manual therapy with exercise in patients with chronic cervical radiculopathy: a randomized clinical trial. Trials. 2021;22(1):716. DOI:10.1186/s13063-021-05690-y
35. Wibault J, Öberg B, Dedering A, et al. Structured postoperative physiotherapy in patients with cervical radiculopathy: 6-month outcomes of a randomized clinical trial. J Neurosurg Spine. 2018;28(1):1-9. DOI:10.3171/2017.5.SPINE16736
36. Peolsson A, Löfgren H, Dedering Å, et al. Postoperative structured rehabilitation in patients undergoing surgery for cervical radiculopathy: a 2-year follow-up of a randomized controlled trial. J Neurosurg Spine. 2019;31(1):60-9. DOI:10.3171/2018.12.SPINE181258
37. Meziat-Filho N, Lima M, Fernandez J, Reis FJJ. Cognitive Functional Therapy (CFT) for chronic non-specific neck pain. J Bodyw Mov Ther. 2018;22(1):32-6. DOI:10.1016/j.jbmt.2017.03.010
38. Rundell SD, Davenport TE. Patient education based on principles of cognitive behavioral therapy for a patient with persistent low back pain: a case report. J Orthop Sports Phys Ther. 2010;40(8):494-501. DOI:10.2519/jospt.2010.3264
39. Zilliox LA. Neuropathic Pain. Continuum (Minneap Minn). 2017;23(2, Selected Topics in Outpatient Neurology):512-32. DOI:10.1212/CON.0000000000000462
40. Arnstein P. Chronic neuropathic pain: issues in patient education. Pain Management Nursing. 2004;5:34-41. DOI:10.1016/j.pmn.2004.10.003
41. Shin JC, Kim NY, Chang SH, et al. Effect of Patient Education on Reducing Medication in Spinal Cord Injury Patients With Neuropathic Pain. Ann Rehabil Med. 2017;41(4):621-30. DOI:10.5535/arm.2017.41.4.621

Авторы

Е.К. Керимова*, А.И. Исайкин, А.С. Романова, М.Г. Башлачев, Кинан Муки

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет), Москва, Россия
*ekaterinakerimova29@yandex.ru

________________________________________________

Ekaterina K. Kerimova*, Aleksei I. Isaikin, Anastasia S. Romanova, Mikhail G. Bashlachev, Kinan Mouki

Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
*ekaterinakerimova29@yandex.ru

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