Driving the lane: a clearer view of facet joint cyst intervention

DePalma, Michael J.

doi:10.1016/j.spinee.2009.08.003

Cited by 6 publications

(6 citation statements)

References 16 publications

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“…The present study utilizes almost all relevant data to appraise the success rate of the percutaneous resolution of the LFJCs and finds perhaps the highest rate (56%) reviewed so far [2 e.g.]. This appears to be because of inclusion of 15 case reports which provide considerable power to analysis.…”

Section: Discussionmentioning

confidence: 97%

“…Two types of cysts recognized under this category are the synovial cysts and ganglion cysts [1]. The synovial cysts have vascularized lining filled with xanthochromic fluid and have communication with facet joint while the ganglion cysts are covered by fibrocartilagenous capsule filled with proteinaceous and gelatinous material and do not communicate with joint [2].…”

Section: Introductionmentioning

confidence: 99%

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Percutaneous Resolution of Lumbar Facet Joint Cysts as an Alternative Treatment to Surgery: A Meta-Analysis

et al. 2014

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PurposeA comprehensive review of the literature in order to analyze data about the success rate of percutaneous resolution of the lumbar facet joint cysts as a conservative management strategy.MethodsA systematic search for relevant articles published during 1980 to May 2014 was performed in several electronic databases by using the specific MeSH terms and keywords. Most relevant data was captured and pooled for the meta-analysis to achieve overall effect size of treatment along with 95% confidence intervals.Results29 studies were included in the meta-analysis. Follow-up duration as mean ± sd (range) was 16±10.2 (5 days to 5.7 years). Overall the satisfactory results (after short- or long-term follow-up) were achieved in 55.8 [49.5, 62.08] % (pooled mean and 95% CI) of the 544 patients subjected to percutaneous lumbar facet joint cyst resolution procedures. 38.67 [33.3, 43.95] % of this population underwent surgery subsequently to achieve durable relief. There existed no linear relationship between the increasing average duration of follow-up period of individual studies and percent satisfaction from the percutaneous resolutions procedure.ConclusionResults shows that the percutaneous cyst resolution procedures have potential to be an alternative to surgical interventions but identification of suitable subjects requires further research.

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Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Percutaneous Resolution of Lumbar Facet Joint Cysts as an Alternative Treatment to Surgery: A Meta-Analysis

et al. 2014

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“…In summary, these cysts can exhibit 3 shapes, appearing as a small protrusion (type 1 and 2), a semicircular cyst (type 3), and a round cyst (type 4) with progression of the cysts (12).…”

Section: E455mentioning

confidence: 99%

A Staged Treatment of Symptomatic Lumbar Intraspinal Synovial Cysts

Kim

et al. 2019

Pain Phys

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Background: Lumbar intraspinal synovial cyst (LISC) refers to a cyst that arises from the zygapophyseal joint capsule of the lumbar spine and contains serous or gelatinous fluid. In cases of LISCs resistant to conservative treatments, various minimally invasive percutaneous spinal techniques (MIPSTs) may be applied prior to open surgery. Objectives: The outcomes of 3-staged MIPSTs for the treatment of symptomatic LISCs resistant to conservative treatments were evaluated. Study Design: An institutional review board approved retrospective chart review. Setting: University hospital inpatients referred to our pain clinic. Methods: Review of charts of all patients who underwent MIPSTs for symptomatic LISCs resistant to conservative treatments during a time period of 13 years at a university hospital pain clinic. Patients with symptomatic LISCs resistant to conservative treatments were treated with 3-staged MIPSTs, including image-guided intraarticular aspiration, cyst distention and rupture, and injection of corticosteroids (ARI), endoscopic cyst enucleation (ECE), and endoscopic superior facetectomy (ESF) by a single pain specialist. A symptom-free period after each intervention was evaluated. Recurrence was defined as the same recurrent symptomatic radicular pain with confirmation of the LISC on magnetic resonance imaging. All patients with a minimum follow-up time of 3 years were included. Results: Of the 40 patients who underwent ARI, 3 patients failed to complete a follow-up and 19 patients (51.4%) who had recurring symptoms received ECE. Ten patients (52.6%) who had rerecurring symptoms after ECE received ESF. There was no recurrence after ESF. Limitations: This retrospective and observational study with a limited number of patients does not represent a high level of evidence. Conclusions: This information provided the recurrence rate after each intervention. Half of the patients who went on to receive ARI experienced recurrence, whereas half of the patients with recurrence who received ECE experienced re-recurrence. ESF treatment resulted in no recurrence within the 3-year study period. Key words: Conservative treatment, endoscopic surgical procedures, facet joint, intraarticular injection, minimally invasive surgical procedures, needle biopsy, nerve root compression, radiculopathy, synovial cysts

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“…Intracanal cystic lesions that develop adjacent to the lumbar facet joint, rst described in 1968 [1], can be distinguished histologically as synovial cysts with xanthochromic uid-lled synovial linings and ganglion cysts covered by a brocartilaginous capsule lled with a proteinaceous and gelatinous material not including synovial lining cells [2,3]. Because the development of both cystic lesion types is accompanied by indistinct degenerative changes in the facet joints, Hsu et al collectively named them "facet cysts" in 1995 [4].…”

Section: Introductionmentioning

confidence: 99%

Usefulness of percutaneous rupture for lumbar facet cysts: A retrospective study

Kanzaki

Morishita²,

Ishihara³

2022

Preprint

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Background: Percutaneous rupture of lumbar facet cysts (LFC) is the only non-surgical treatment able to directly reduce cysts. However, this is not yet a common procedure, and its effectiveness, including the evaluation of complications, remains unclear. This study aimed to evaluate the clinical outcomes of percutaneous rupture for LFC and elucidate whether this minimally invasive procedure could become an alternative to surgeries for cases resistant to conservative treatments. Methods: This study investigated 51 symptomatic patients with LFC for whom conservative treatments were ineffective and who underwent percutaneous rupture of the LFC. All patients were followed-up for >2 years after the treatment. Clinical evaluations (Visual Analogue Scale [VAS], recovery rate calculated with Japanese Orthopedic Association scores) and radiographic evaluations (size of LFC based on magnetic resonance imaging [MRI]) were performed from pretreatment to final follow-up. Results: Successful LFS rupture, without hospitalization and general anesthesia, was achieved in 43 patients. No serious complications occurred during treatment through the last observation. Satisfactory clinical results were obtained (VAS: 11.1 mm, recovery rate: 83.1 %), and significant reduction of LFC was recognized in all cases based on post-treatment MRI. No successful rupture cases required subsequent surgical treatments, although there were 3 cases of LFC recurrence that required an additional percutaneous rupture treatment. Conclusions: Percutaneous rupture for LFC is not only a safe and minimally invasive procedure without any serious complications or requirements for hospitalization and general anesthesia, but also a very useful procedure that can prevent surgery for cases resistant to conservative treatments.

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Driving the lane: a clearer view of facet joint cyst intervention

Cited by 6 publications

References 16 publications

Percutaneous Resolution of Lumbar Facet Joint Cysts as an Alternative Treatment to Surgery: A Meta-Analysis

Percutaneous Resolution of Lumbar Facet Joint Cysts as an Alternative Treatment to Surgery: A Meta-Analysis

A Staged Treatment of Symptomatic Lumbar Intraspinal Synovial Cysts

Usefulness of percutaneous rupture for lumbar facet cysts: A retrospective study

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