A Ligamentum Flavum Cyst of Lumbar Spine in a 67-Year-old Man Presenting with Neurogenic Claudication

Aims: Ligamentum flavum cysts are rare and may lead to compression of the spinal cord or surrounding structures which ultimately may require surgery. We report a case of a ligamentum flavum cyst presenting with neurogenic claudication with its clinical, radiological, and histopathological features.

Presentation of Case: We present a case of a 67-year-old male with chronic back pain, progressive bilateral neurogenic claudication, and worsening radicular symptoms in the right leg. A 9-mm cystic mass was revealed by MRI in the epidural space at the L4-5 disc level. After successful resection of the cyst, complete remission was achieved.

Discussion: Ligamentum flavum cysts may be confused with other benign cystic lesions called juxtafacet cysts comprising synovial cysts and ganglion cysts. In addition to typical histopathological findings, the anatomic location confirms the diagnosis. Surgical decompression with complete excision has been shown to be the most successful treatment strategy.

Conclusion: Ligamentum flavum cysts are uncommon causes of spinal compression. Removal of these lesions provides the disappearance of patients’ complaints.