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01-11-2016 | Original Article - Neurosurgical Anatomy

The mechanism underlying combined medial and lateral plantar and tibial intraneural ganglia in the tarsal tunnel

Authors: Albert M. Isaacs, Rajiv Midha, Nicholas M. Desy, Kimberly K. Amrami, Robert J. Spinner

Published in: Acta Neurochirurgica | Issue 11/2016

Abstract

Intraneural ganglion cysts in the tarsal tunnel are rare. We present a patient who had an intraneural ganglion cyst involving the medial and lateral plantar and distal tibial nerves. Magnetic resonance imaging revealed evidence to support the joint-related (i.e., subtalar) origin of the cyst. Careful reinterpretation of the imaging supported a phasic mechanism (i.e., cross-over) to explain the interrelated pathogenesis of the intraneural cyst within the three nerves. This mechanism is analogous to that described for the prototypes—the peroneal, tibial and sciatic nerves in the knee region—and can be generalized to other nerves in the foot and ankle region. We believe that understanding the pathogenesis sheds light on the effective treatment.

Blitz NM, Prestridge J, Amrami KK, Spinner RJ (2008) A posttraumatic, joint-connected sural intraneural ganglion cyst—with a new mechanism of intraneural recurrence: a case report. J Foot Ankle Surg 47:199–205CrossRefPubMed

Choi JS, Kim KH, Kwak JH, Park HG, Lee SW (2011) Intraneural ganglion cyst in foot and ankle. J Korean Foot Ankle Soc 15:223–231

Desy NM, Wang H, Elshiekh MA, Tanaka S, Choi TW, Howe BM, Spinner RJ (2016) Intraneural ganglion cysts: a systematic review and reinterpretation of the world’s literature. J Neurosurg 22:1–16

Oishi C, Sonoo M, Tachibana S, Chiba A (2015) Tarsal tunnel syndrome (TTS) diagnosed by the double-peaked compound muscle action potential (CMAP) of the tibial nerve. Clin Neurophysiol 126:e58–e59CrossRef

Prado M, Mendes A, Resende M (2014) Recurrent tibial nerve cysts at the ankle joint. A case report and literature review. https://www.aofas.org/PRC/meeting/Documents/recurrenttibialnervecysts.pdf. Accessed 15 June 2016

Samarawickrama D, Therimadasamy AK, Chan YC, Vijayan J, Wilder-Smith EP (2016) Nerve ultrasound in electrophysiologically verified tarsal tunnel syndrome. Muscle Nerve 53:906–912CrossRefPubMed

Spinner RJ (2005) Re: tarsal tunnel syndrome caused by epineural ganglion of the posterior tibial nerve. J Foot Ankle Surg 44:74–75CrossRefPubMed

Spinner RJ, Amrami KK (2010) Superficial peroneal intraneural ganglion cyst originating from the inferior tibiofibular joint: the latest chapter in the book. J Foot Ankle Surg 49:575–578CrossRefPubMed

Spinner RJ, Amrami KK, Hamlat A (2008) Collaborative follow-up. Acta Neurochir (Wien) 150:93–96CrossRef

10.

Spinner RJ, Amrami KK, Ibrahim Elshiekh MA, Blitz NM (2012) Sural intraneural ganglion cysts are joint-related. Arch Plast Surg 39:77–79CrossRefPubMedPubMedCentral

11.

Spinner RJ, Amrami KK, Wolanskyj AP, Desy NM, Wang H, Benarroch EE, Skinner JA, Rock MG, Scheithauer BW (2007) Dynamic phases of peroneal and tibial intraneural ganglia formation: a new dimension added to the unifying articular theory. J Neurosurg 107:296–307CrossRefPubMed

12.

Spinner RJ, Atkinson JL, Tiel RL (2003) Peroneal intraneural ganglia: the importance of the articular branch. A unifying theory. J Neurosurg 99:330–343CrossRefPubMed

13.

Spinner RJ, Dellon AL, Rosson GD, Anderson SR, Amrami KK (2007) Tibial intraneural ganglia in the tarsal tunnel: is there a joint connection? J Foot Ankle Surg 46:27–31CrossRefPubMed

14.

Spinner RJ, Hébert-Blouin MN, Rock MG, Amrami KK (2011) Extreme intraneural ganglion cysts. J Neurosurg 114:217–224CrossRefPubMed

15.

Vosoughi AR, Klaue K (2016) Huge juxtaneural ganglion cyst of the tibial nerve. A case report and review of the literature. FussSprungg, In Press 10.1016/j.fuspru.2016.1005.1001. Accessed 8 July 2016

Title: The mechanism underlying combined medial and lateral plantar and tibial intraneural ganglia in the tarsal tunnel
Authors: Albert M. Isaacs
Rajiv Midha
Nicholas M. Desy
Kimberly K. Amrami
Robert J. Spinner
Publication date: 01-11-2016
Publisher: Springer Vienna
Published in: Acta Neurochirurgica / Issue 11/2016
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-016-2930-1

At a glance: The STEP trials

Springer Medicine

The mechanism underlying combined medial and lateral plantar and tibial intraneural ganglia in the tarsal tunnel

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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