{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T03:02:33Z","timestamp":1771383753827,"version":"3.50.1"},"reference-count":39,"publisher":"Georg Thieme Verlag KG","issue":"02","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurol Surg A Cent Eur Neurosurg"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Ganglion cysts of the posterior longitudinal ligament (PLL) are a rare cause of lumbar radicular pain and claudication, primarily affecting young athletic males. These cysts are often linked to repetitive trauma and degenerative changes in the PLL, potentially aggravated by disc degeneration. Diagnosis is typically achieved through magnetic resonance imaging (MRI), with surgical excision being the preferred treatment in symptomatic cases. This systematic review consolidates the current knowledge on PLL ganglion cysts, examining clinical characteristics, diagnostic findings, and surgical outcomes to provide a basis for future research and clinical management.<\/jats:p>\n                  <jats:p>A systematic literature search was conducted in PubMed, Embase, Cochrane Library, and Web of Science, including studies from inception to June 2024. Search terms included \u201cganglion cyst,\u201d \u201cposterior longitudinal ligament,\u201d \u201cPLL,\u201d and \u201clumbar spine,\u201d among others. Studies published in English and French were reviewed if they reported on ganglion cysts of the PLL with clinical or radiological data. Data on demographics, symptoms, imaging findings, treatment approaches, outcomes, and follow-up were extracted. Due to the heterogeneity of the included studies, a narrative synthesis was performed, focusing on clinical presentation, diagnostic criteria, surgical techniques, and recurrence rates.<\/jats:p>\n                  <jats:p>A total of 14 studies comprising 20 patients were analyzed. The majority (90%) were male, with a mean age of 30.2 years (standard deviation [SD]\u2009=\u200911.47). The most common presenting symptom was radicular pain, primarily left-sided (70%). Disc degeneration was reported in 85% of cases, supporting a link between degenerative disc disease and PLL cyst formation. MRI revealed hypointense cysts on T1-weighted images and hyperintense on T2, aiding in differentiation from other intraspinal pathologies. Surgical excision was performed in all cases, with hemilaminectomy (50%) and interlaminar approaches (40%) being the most common techniques. Minimally invasive endoscopic methods were used in one case. Complete recovery was reported in 65% of patients, with a mean follow-up of 13.8 months (SD\u2009=\u200912.1). Recurrence data were limited due to inconsistent follow-up.<\/jats:p>\n                  <jats:p>This systematic review highlights the clinical and imaging characteristics of PLL ganglion cysts, with MRI as a critical tool for diagnosis. Surgical management, particularly hemilaminectomy and interlaminar approaches, is effective in providing symptom relief and preventing recurrence. Although minimally invasive techniques show promise, further research is needed to confirm their efficacy. Given the rarity of PLL cysts, tailored treatment and larger studies with standardized follow-up are essential to improve understanding and management of this condition.<\/jats:p>","DOI":"10.1055\/a-2642-7869","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T23:36:06Z","timestamp":1758238566000},"page":"142-153","source":"Crossref","is-referenced-by-count":0,"title":["Management and Outcomes of Ganglion Cysts of the Posterior Longitudinal Ligament: A Systematic Review of Diagnostic and Surgical Approaches"],"prefix":"10.1055","volume":"87","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9465-2506","authenticated-orcid":false,"given":"Gianluca","family":"Scalia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Specialist Hospital Garibaldi, Catania, Sicilia, Italy"},{"name":"Department of Medicine and Surgery, Kore University of Enna, Enna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"Graziano","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Garibaldi, Catania, Sicilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8221-7195","authenticated-orcid":false,"given":"Salvatore","family":"Marrone","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Azienda Sanitaria Provinciale di Caltanissetta, Sant'Elia Hospital, Caltanissetta, Sicilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Ferini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Kore University of Enna, Enna, Italy"},{"name":"Department of Radiation Oncology, Rem Radioterapia srl, Viagrande, Sicilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliana","family":"Giurato","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Unit, National Specialist Hospital Garibaldi, via palermo, catania, Catania, Sicilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni Federico","family":"Nicoletti","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Specialist Hospital Garibaldi, Catania, Sicilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Galvano","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Imaging, Interventional Radiology and Neuroradiology, Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Garibaldi, Catania, Sicilia, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1573-431X","authenticated-orcid":false,"given":"Giuseppe Emmanuele","family":"Umana","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, Kore University of Enna, Enna, Italy"},{"name":"Department of Neurosurgery, Cannizzaro Hospital, Catania, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"issue":"11","key":"ref1","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1097\/00007632-199211000-00030","article-title":"A ganglion cyst in the lumbar spinal canal. A case report","volume":"17","author":"Y Ogawa","year":"1992","journal-title":"Spine"},{"issue":"16","key":"ref2","doi-asserted-by":"crossref","first-page":"2528","DOI":"10.1097\/00007632-199312000-00026","article-title":"Gas-containing \u201cganglion\u201d cyst of lumbar posterior longitudinal ligament at L3. Case report","volume":"18","author":"R M Lin","year":"1993","journal-title":"Spine"},{"issue":"03","key":"ref3","first-page":"125","article-title":"Two cases of ganglion cysts in the lumbar spinal canal","volume":"12","author":"T Shiono","year":"1994","journal-title":"Radiat Med"},{"issue":"14","key":"ref4","doi-asserted-by":"crossref","first-page":"1633","DOI":"10.1097\/00007632-199507150-00013","article-title":"Nerve root compression by a ganglion cyst of the lumbar anulus fibrosus. A case report","volume":"20","author":"M Kornberg","year":"1995","journal-title":"Spine"},{"issue":"08","key":"ref5","first-page":"579","article-title":"[Cyst of the lumbar posterior longitudinal ligament. An unusual cause of non-discal sciatica]","volume":"77","author":"D Barea","year":"1996","journal-title":"J Radiol"},{"issue":"09","key":"ref6","doi-asserted-by":"crossref","first-page":"632","DOI":"10.1038\/sj.sc.3100442","article-title":"Ganglion cyst of the posterior longitudinal ligament causing lumbar radiculopathy: case report","volume":"35","author":"H Baba","year":"1997","journal-title":"Spinal Cord"},{"issue":"11","key":"ref7","doi-asserted-by":"crossref","first-page":"1812","DOI":"10.1007\/s003300000445","article-title":"L5 radicular pain related to a cystic lesion of the posterior longitudinal ligament","volume":"10","author":"C Le Breton","year":"2000","journal-title":"Eur Radiol"},{"key":"ref8","first-page":"543","article-title":"Spinal ganglion cyst of lumbar posterior longitudinal ligament","volume":"29","author":"S W Roh","year":"2000","journal-title":"J Korean Neurosurg Soc"},{"key":"ref9","first-page":"399","article-title":"Posterior longitudinal ligament cyst causing radiculopathy. Case illustration","volume":"97","author":"M Miscusi","year":"2002","journal-title":"J Neurosurg"},{"issue":"04","key":"ref10","doi-asserted-by":"crossref","first-page":"E818","DOI":"10.1227\/01.neu.0000175866.85346.24","article-title":"\u201cDisc cysts\u201d and \u201cposterior longitudinal ligament ganglion cysts\u201d: synonymous entities? Report of three cases and literature review","volume":"57","author":"L A Marshman","year":"2005","journal-title":"Neurosurgery"},{"issue":"07","key":"ref11","doi-asserted-by":"crossref","first-page":"298","DOI":"10.2176\/nmc.48.298","article-title":"Lumbar synovial cysts: experience with nine cases","volume":"48","author":"G Ayberk","year":"2008","journal-title":"Neurol Med Chir (Tokyo)"},{"issue":"04","key":"ref12","doi-asserted-by":"crossref","first-page":"e11","DOI":"10.1016\/j.spinee.2008.05.013","article-title":"L5 radiculopathy caused by a ganglion cyst of the posterior longitudinal ligament in a teenager","volume":"9","author":"M Mizutamari","year":"2009","journal-title":"Spine J"},{"issue":"04","key":"ref13","doi-asserted-by":"crossref","first-page":"298","DOI":"10.3340\/jkns.2010.47.4.298","article-title":"Ganglion cyst of the posterior longitudinal ligament causing lumbar radiculopathy","volume":"47","author":"S M Cho","year":"2010","journal-title":"J Korean Neurosurg Soc"},{"issue":"05","key":"ref14","first-page":"e60604","article-title":"Evaluation and treatment of lumbar spine extradural cysts: a narrative review","volume":"16","author":"M Badra","year":"2024","journal-title":"Cureus"},{"issue":"03","key":"ref15","doi-asserted-by":"crossref","first-page":"449","DOI":"10.3171\/jns.1994.81.3.0449","article-title":"Hemorrhage into a lumbar synovial cyst causing an acute cauda equina syndrome. Case report","volume":"81","author":"S B Tatter","year":"1994","journal-title":"J Neurosurg"},{"issue":"07","key":"ref16","first-page":"1373","article-title":"Intraspinal extradural cysts communicating with adjacent herniated disks: imaging characteristics and possible pathogenesis","volume":"20","author":"K Kono","year":"1999","journal-title":"AJNR Am J Neuroradiol"},{"issue":"01","key":"ref17","doi-asserted-by":"crossref","first-page":"e23","DOI":"10.1016\/j.spinee.2015.08.044","article-title":"Posterior epidural cyst associated with Baastrup disease","volume":"16","author":"M Gold","year":"2016","journal-title":"Spine J"},{"key":"ref18","first-page":"153","article-title":"Ganglion cyst in the lumbar spine","volume":"36","author":"J M Kim","year":"2004","journal-title":"J Korean Neurosurg Soc"},{"issue":"01","key":"ref19","doi-asserted-by":"crossref","first-page":"191","DOI":"10.2214\/ajr.182.1.1820191","article-title":"Intraspinal posterior epidural cysts associated with Baastrup's disease: report of 10 patients","volume":"182","author":"C K Chen","year":"2004","journal-title":"AJR Am J Roentgenol"},{"key":"ref20","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/1752-1947-6-92","article-title":"A cervical ligamentum flavum cyst in an 82-year-old woman presenting with spinal cord compression: a case report and review of the literature","volume":"6","author":"A G Brotis","year":"2012","journal-title":"J Med Case Rep"},{"issue":"12","key":"ref21","doi-asserted-by":"crossref","first-page":"653","DOI":"10.2176\/nmc.45.653","article-title":"Cyst of the ligamentum flavum\u2013case report","volume":"45","author":"S Asamoto","year":"2005","journal-title":"Neurol Med Chir (Tokyo)"},{"issue":"01","key":"ref22","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1177\/230949900901700118","article-title":"Facet cyst haematoma in the lumbar spine: a report of four cases","volume":"17","author":"N Miyatake","year":"2009","journal-title":"J Orthop Surg (Hong Kong)"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1016\/j.wneu.2017.11.075","article-title":"Midline ligamentum flavum cyst of lumbar spine","volume":"110","author":"K Shah","year":"2018","journal-title":"World Neurosurg"},{"issue":"08","key":"ref24","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1136\/jnnp.2008.169169","article-title":"Ganglion cyst of the ligamentum flavum: a rare cause of cervical spinal cord compression. A case report","volume":"81","author":"V F Muzii","year":"2010","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"01","key":"ref25","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.radcr.2017.09.009","article-title":"Ligamentum flavum cyst: an uncommon but recognizable and surgically correctable category of juxtafacet cyst","volume":"13","author":"W M Nizamani","year":"2017","journal-title":"Radiol Case Rep"},{"issue":"05","key":"ref26","doi-asserted-by":"crossref","first-page":"326","DOI":"10.1016\/j.clinimag.2006.05.026","article-title":"Discal cyst of the lumbar spine: MR imaging features","volume":"30","author":"H K Lee","year":"2006","journal-title":"Clin Imaging"},{"issue":"01","key":"ref27","doi-asserted-by":"crossref","first-page":"18","DOI":"10.14245\/kjs.2014.11.1.18","article-title":"Ligamentum flavum cyst of lumbar spine: a case report and literature review","volume":"11","author":"D H Seo","year":"2014","journal-title":"Korean J Spine"},{"key":"ref28","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.wneu.2017.02.075","article-title":"Endoscopic surgical treatment of lumbar synovial cyst: detailed account of surgical technique and report of 11 consecutive patients","volume":"103","author":"J M Oertel","year":"2017","journal-title":"World Neurosurg"},{"issue":"02","key":"ref29","doi-asserted-by":"crossref","first-page":"144","DOI":"10.55095\/achot2012\/022","article-title":"[Percutaneous dynamic interspinous stabilisation for the treatment of juxtafacet cysts of the lumbar spine: prospective study]","volume":"79","author":"L Hrab\u00e1lek","year":"2012","journal-title":"Acta Chir Orthop Traumatol Cech"},{"issue":"02","key":"ref30","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s10195-010-0094-y","article-title":"Ligamentum flavum cyst in the lumbar spine: a case report and review of the literature","volume":"11","author":"H Taha","year":"2010","journal-title":"J Orthop Traumatol"},{"issue":"19","key":"ref31","doi-asserted-by":"crossref","first-page":"2112","DOI":"10.1097\/00007632-200110010-00014","article-title":"Intraspinal cyst communicating with the intervertebral disc in the lumbar spine: discal cyst","volume":"26","author":"K Chiba","year":"2001","journal-title":"Spine"},{"issue":"01","key":"ref32","doi-asserted-by":"crossref","first-page":"137","DOI":"10.3171\/jns.1988.69.1.0137","article-title":"Intervertebral disc space cyst simulating a recurrent herniated nucleus pulposus. Case report","volume":"69","author":"J C Grabel","year":"1988","journal-title":"J Neurosurg"},{"key":"ref33","first-page":"273151","article-title":"Percutaneous endoscopic discectomy via transforaminal route for discal cyst","volume":"2015","author":"S C Jha","year":"2015","journal-title":"Case Rep Orthop"},{"issue":"02","key":"ref34","doi-asserted-by":"crossref","first-page":"e9","DOI":"10.1016\/j.spinee.2007.12.013","article-title":"Postoperative annular pseudocyst: report of two cases with an unusual complication after microdiscectomy, and successful treatment by percutaneous aspiration and steroid injection","volume":"9","author":"P M Young","year":"2009","journal-title":"Spine J"},{"issue":"06","key":"ref35","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1177\/1553350614525668","article-title":"Operation of lumbar zygoapophyseal joint cysts using a full-endoscopic interlaminar and transforaminal approach: prospective 2-year results of 74 patients","volume":"21","author":"M Komp","year":"2014","journal-title":"Surg Innov"},{"key":"ref36","first-page":"S100","article-title":"Symptomatic intraspinal ganglion cyst of the nerve root sheath","volume":"10","author":"M Hemmati","year":"1989","journal-title":"AJNR Am J Neuroradiol"},{"issue":"12","key":"ref37","doi-asserted-by":"crossref","first-page":"829","DOI":"10.5435\/JAAOS-D-14-00461","article-title":"Evaluation and treatment of lumbar facet cysts","volume":"24","author":"B S Boody","year":"2016","journal-title":"J Am Acad Orthop Surg"},{"issue":"09","key":"ref38","doi-asserted-by":"crossref","first-page":"e631","DOI":"10.1016\/j.spinee.2016.04.005","article-title":"Successful percutaneous management of symptomatic central posterior epidural Baastrup cyst: a potential surgical sparing option?","volume":"16","author":"J Breed","year":"2016","journal-title":"Spine J"},{"issue":"04","key":"ref39","doi-asserted-by":"crossref","first-page":"365","DOI":"10.22603\/ssrr.2020-0023","article-title":"A case of central posterior epidural cyst associated with Baastrup's disease punctured percutaneously using fluoroscopy with a good outcome","volume":"4","author":"S Baba","year":"2020","journal-title":"Spine Surg Relat Res"}],"container-title":["Journal of Neurological Surgery Part A: Central European Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2642-7869.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T02:02:59Z","timestamp":1771380179000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2642-7869"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,18]]},"references-count":39,"journal-issue":{"issue":"02","published-online":{"date-parts":[[2026,2,12]]},"published-print":{"date-parts":[[2026,3]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2642-7869","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["2193-6315","2193-6323"],"issn-type":[{"value":"2193-6315","type":"print"},{"value":"2193-6323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9,18]]}}}