Evidence map›Paper›PMID 40632231›Full record

SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025

Lumbar discal cysts: a systematic literature review of diagnostic features and treatment strategies.

Edoardo Agosti, Lucio De Maria, Francesco Belotti, Enza Gatti, Marco Bruzzone, Paolo Amaddeo, Gianandrea Bellini, Riccardo Bergomi, Marco Fontanella, Nazzareno Fagoni and 1 more

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Lumbar Epidural Cystic Lesion Associated WithCase reports in infectious diseases · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Edoardo AgostiDivision of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Largo Spedali Civili 1, 25123, Brescia, Italy.
Lucio De MariaDivision of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Largo Spedali Civili 1, 25123, Brescia, Italy. luciodemaria@gmail.com.ORCID http://orcid.org/0000-0003-4062-5665
Francesco BelottiDivision of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Largo Spedali Civili 1, 25123, Brescia, Italy.
Enza GattiDepartment of Radiology, Neuroradiology Unit, ASST Spedali Civili University Hospital, Brescia, Italy.
Marco BruzzoneSassuolo Calcio, Sassuolo, Italy.
Paolo AmaddeoCR Lombardo FMSI Chair, Bergamo, Italy.
Gianandrea BelliniAtalanta Bergamasca Calcio, Bergamo, Italy.
Riccardo BergomiDivision of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Largo Spedali Civili 1, 25123, Brescia, Italy.
Marco FontanellaDivision of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Largo Spedali Civili 1, 25123, Brescia, Italy.
Nazzareno FagoniDepartment of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
Claudio CornaliDivision of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Largo Spedali Civili 1, 25123, Brescia, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeDiscal cysts are epidural masses connected to the intervertebral disk, primarily affecting younger individuals. Distinguishing discal cysts from other cystic masses within the epidural space is challenging due to overlapping clinical symptoms and neuroimaging characteristics. This systematic review aims to analyze the diagnostic features and management strategies of lumbar discal cysts.

methodsA comprehensive literature search was conducted following PRISMA guidelines. Relevant studies published between January 1990 and July 2023 were included. Data on diagnostic features, management strategies, and outcomes were extracted. The quality of included studies was assessed using the Newcastle-Ottawa Scale.

resultsThis systematic review examined a total of 52 articles and 118 cases of discal cysts, including one institutional case. The median age of the patients was 30 years, with a higher prevalence of males. The median follow-up period was 12 months. The most common symptoms reported were leg pain (87.3%) and low back pain (71.2%). Physical examination findings were positive in 45.5% of patients, including hypoesthesia (23.2%), leg weakness (18.8%), and positive straight leg raise test (19.6%). All patients underwent spinal lumbar MRI, which revealed discal nodularity that appeared hypointense in T1-weighted sequences with cystic wall enhancement and hyperintense in T2-weighted sequences. Contrast-enhanced MRI showed enhancement of the cyst wall in the cases where it was performed. Discal cysts were mainly at the L4-L5 level (44.9%) and L5-S1 level (26.3%), with a ventrolateral (94.9%), ventral (4.2%), or lateral position (0.8%). Various treatment modalities were used, including conservative management (5.9%), microscopic cyst resection and discectomy (32.2%), microscopic cyst resection (28.8%), microendoscopic cyst resection (22.1%), and CT-guided cyst aspiration (11%). The majority of patients experienced progressive improvement of symptoms.

conclusionDiscal cysts generally present with low back and radicular pain and can be diagnosed using MRI. Differential diagnoses must be considered to ensure accurate diagnosis and appropriate management. Conservative treatment is typically the initial approach, while surgical interventions are considered for refractory cases.

Indexed as

CystsIntervertebral DiscLumbar VertebraeAdultHumansLow Back PainMagnetic Resonance ImagingMaleDifferential diagnosisDiscal cystRadiculopathySystematic reviewTreatment

Identifiers

PMID40632231

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.