Abstract
Superficial radial intraneural ganglion cysts are rare. Only nine previous cases have been described. We provide two examples with a wrist joint connection and review the literature to provide further support for the unifying articular (synovial) theory for the pathogenesis and treatment of intraneural ganglia.
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A well-written and well-documented article that comprehensively reviews the literature on intraneural ganglion cysts involving peripheral nerves of the upper extremity. It also provides solid additional evidence, in two clinical cases, supporting the critical role played by an articular branch in the formation of these cysts when involving the superficial radial sensory nerve at the wrist. These findings have significance not only in understanding the pathophysiology of how these cysts develop within a nerve, but also in achieving long-term relief of symptoms by intraoperatively finding, identifying, and then surgically transecting the articular branch feeding the cyst.
Michel Kliot
CA, USA
This is a succinct report of two cases of patients with cysts of the superficial radial nerve. The authors describe the connection of the cysts to wrist joints.Dr. Spinner’s group has been champions of the theory that intraneural cysts most often are related to connections of articular branches of the nerve to joints. In this report, they extend their theory to the superficial radial nerve. I believe that all surgeons should look for such a connection when treating intraneural ganglion cysts. It would be helpful to perform preoperative MRI targeted and identifying the connections as outlined by the authors.
Allan Friedman
NC, USA
This article is part of the Topical Collection on Peripheral Nerves
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Spinner, R.J., Mikami, Y., Desy, N.M. et al. Superficial radial intraneural ganglion cysts at the wrist. Acta Neurochir 160, 2479–2484 (2018). https://doi.org/10.1007/s00701-018-3715-5
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DOI: https://doi.org/10.1007/s00701-018-3715-5