Peroneal and tibial intraneural ganglion cysts in the knee region: A technical note

Robert J. Spinner, M. N. Hébert-Blouin, Kimberly K. Amrami, Michael G. Rock

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

BACKGROUND: Recent research has resulted in an improved understanding of the pathogenesis and treatment of intraneural ganglia, particularly with respect to the most common form, the peroneal nerve at the fibular neck region. OBJECTIVE: To outline the mechanism for the development and propagation of intraneural ganglia located in the knee region, along with their treatment, as well as highlight how shared principles can be exploited for successful treatment of the more commonly occurring peroneal intraneural ganglia. METHODS: A surgical approach has been developed for peroneal intraneural cysts based on the pathogenesis. The treatment of the less common tibial intraneural cysts is designed along the same principles. RESULTS: A strategy consisting of (1) disarticulation (resection) of the superior tibiofibular joint (ie, the source), (2) disconnection of the articular branch connection (ie, the conduit), and (3) decompression (rather than resection) of the cyst has improved outcomes and eliminated intraneural recurrences in peroneal intraneural cysts. These same principles and techniques can be applied to the rarer tibial intraneural ganglia derived from the same joint. The mechanism of development and propagation for intraneural cysts in the knee region as well as a surgical technique and its rational are described and illustrated. CONCLUSION: Understanding the joint-related basis of intraneural cysts leads to simple targeted surgery that addresses the joint, its articular branch, and the cyst. The success of the shared surgical strategy for both peroneal and tibial intraneural ganglia confirms the principles of the unifying articular theory.

Original languageEnglish (US)
JournalNeurosurgery
Volume67
Issue numberSUPPL. 1
DOIs
StatePublished - Dec 2010

Fingerprint

Ganglion Cysts
Cysts
Knee
Ganglia
Joints
Disarticulation
Peroneal Nerve
Therapeutics
Knee Joint
Decompression
Neck
Recurrence

Keywords

  • Cysts
  • Intraneural ganglia
  • Recurrence
  • Treatment

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Peroneal and tibial intraneural ganglion cysts in the knee region : A technical note. / Spinner, Robert J.; Hébert-Blouin, M. N.; Amrami, Kimberly K.; Rock, Michael G.

In: Neurosurgery, Vol. 67, No. SUPPL. 1, 12.2010.

Research output: Contribution to journalArticle

Spinner, Robert J. ; Hébert-Blouin, M. N. ; Amrami, Kimberly K. ; Rock, Michael G. / Peroneal and tibial intraneural ganglion cysts in the knee region : A technical note. In: Neurosurgery. 2010 ; Vol. 67, No. SUPPL. 1.
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