Hemilaminoplasty for the treatment of lumbar intraspinal synovial cysts (LISCs) and literature review

ZhenBo, Zuo; Li, Huanting; Wang, Jin; Gong, Haifeng; Fang, Yuan; Li, Ming

doi:10.1007/s00586-014-3570-x

Cited by 15 publications

(8 citation statements)

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“…5,27 However, to maintain stability, smaller and less traumatic facet-sparing approaches are favored in the literature. 71,79,84,86,88,93,102 Partial resection of the medial aspects of the facet was necessary in only one-third of cases in the present series.…”

Section: Treatment Optionsmentioning

confidence: 60%

Synovial cysts of the spine: long-term follow-up after surgical treatment of 141 cases in a single-center series and comprehensive literature review of 2900 degenerative spinal cysts

Bruder

Cattani

Geßler

et al. 2017

Journal of Neurosurgery: Spine

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OBJECTIVESynovial cysts of the spine are rare lesions, predominantly arising in the lumbar region. Despite their generally benign behavior, they can cause severe symptoms due to compression of neural structures in the spinal canal. Treatment strategies are still a matter of discussion. The authors performed a single-center survey and literature search focusing on long-term results after minimally invasive surgery.METHODSA total of 141 consecutive patients treated for synovial cysts of the lumbar spine between 1997 and 2014 in the authors’ department were analyzed. Medical reports with regard to signs and symptoms, operative findings, complications, and short-term outcome were reviewed. Assessment of long-term outcome was performed with a standardized telephone questionnaire based on the Oswestry Disability Index (ODI). Furthermore, patients were questioned about persisting pain, symptoms, and further operative procedures, if any. Subjective satisfaction was classified as excellent, good, fair, or poor based on the Macnab classification.RESULTSThe approach most often used for synovial cyst treatment was partial hemilaminectomy in 70%; hemilaminectomy was necessary in 27%. At short-term follow-up, the presence of severe and moderate leg pain had decreased from 93% to 5%. The presence of low-back pain decreased from 90% to 5%. Rates of motor and sensory deficits were reduced from 40% to 14% and from 45% to 6%, respectively. The follow-up rate was 58%, and the mean follow-up period was 9.3 years. Both leg pain and low-back pain were still absent in 78%. Outcome based on the Macnab classification was excellent in 80%, good in 14%, fair in 1%, and poor in 5%. According to the ODI, 78% of patients had no or only minimal disability, 16% had moderate disability, and 6% had severe disability at the time of follow-up. In this cohort, 7% needed surgery due to cyst recurrence, and 9% required a delayed stabilization procedure after the initial operation.CONCLUSIONSSurgical treatment with resection of the cyst provides favorable results in outcome. Excellent or good outcome persisting for a long-term follow-up period can be achieved in the vast majority of cases. Complication rates are low despite an increased risk of dural injury. With facet-sparing techniques, the stability of the segment can be preserved, and resection of spinal synovial cysts does not necessarily require segmental fusion.

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Section: Treatment Optionsmentioning

confidence: 60%

Synovial cysts of the spine: long-term follow-up after surgical treatment of 141 cases in a single-center series and comprehensive literature review of 2900 degenerative spinal cysts

Bruder

Cattani

Geßler

et al. 2017

Journal of Neurosurgery: Spine

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“…Nevertheless, both intraspinal hematomas and cysts display various MRI signals [4][5][6], making it di cult to distinguish these two diseases when the shape of the mass is cyst-like on MRI scans, as in our case. A careful medical history review to determine the basis of the pain (e.g., facet joint block, acupuncture, epidural injection) is helpful for pinpointing the correct diagnosis.…”

Section: Discussionmentioning

confidence: 92%

Intraspinal Epidural Hematoma Caused By Acupuncture Mimicking An Intraspinal Synovial Cyst: A Case Report 

Qiu¹,

Zhou²,

H³

et al. 2020

Preprint

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Background Intraspinal hematoma is a rare complication of acupuncture. A few cases of subdural hematoma or epidural hematoma have been reported, with most of them in a fusiform shape, making the hematomas easy to identify on magnetic resonance imaging (MRI) scans. Case presentation A 49-year-old man presented with back pain that radiated into his lower limb that had appeared during acupuncture of his back. After admission, MRI was performed and indicated an L5/S1 intraspinal mass that had an oval shape, resembling an intraspinal cyst. The patient underwent surgery to remove the mass, which was confirmed to be a hematoma. Conclusion Intraspinal hematomas appear with various intensity signals and shapes on MRI, making its differential diagnosis difficult. A carefully medical history review (to determine if the pain derives from a puncture-type treatment or an injury) and surgical exploration may be helpful for identifying this condition.

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“…There is controversy as to whether a nonsurgical or surgical approach is the appropriate treatment for these cysts (8,12,(22)(23)(24). Synovial cysts that do not re-…”

Section: Discussionmentioning

confidence: 99%

Outcome of Percutaneous Lumbar Synovial Cyst Rupture in Patients with Lumbar Radiculopathy

Eshraghi

2016

Pain Phys

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Background: Lumbar synovial cysts can result from spondylosis of facet joints. These cysts can encroach on adjacent nerve roots, causing symptoms of radiculopathy. Currently the only definitive treatment for these symptoms is surgery, which may involve laminectomy or laminotomy, with or without spinal fusion. Surgery has been reported to successfully relieve radicular pain in 83.5% of patients by Zhenbo et al. Little information is available concerning the efficacy and outcome of percutaneous fluoroscopic synovial cyst rupture for treatment of facet joint synovial cysts. Objective: The goal of this investigation was to assess the efficacy of fluoroscopically guided lumbar synovial cyst rupture, in particular for its relief of radicular symptoms and its potential to reduce the need for surgical intervention. Study Design: Retrospective evaluation of a case series. Setting: University hospital and urban public health care system. Methods: With approval from the Institutional Review Board of Case Western Reserve University/ MetroHealth Medical Center, we reviewed the medical charts of patients with lumbar radiculopathy who underwent percutaneous lumbar synovial cyst rupture. The 30 patients in the cohort were treated by one pain specialist between 2006 and 2013. These patients were diagnosed with moderate to severe lower back pain, radiculopathy, and ranged in age from 42 to 80 years. Patients were followed up for a minimum of 6 months and up to 24 months. Pre- and post-procedure pain assessments were reviewed by clinical chart review. In addition post-procedure pain assessments and duration of pain relief were obtained with telephone interviews. Pain had been reported by the patients using a numeric rating scale of 0 – 10 (0 = no pain; 10 = worst possible pain). Charts were reviewed to determine if surgery was eventually performed to correct radicular symptoms. Results: More than 6 months of pain relief was achieved in 14/30 patients (46%) and between one and 6 months of pain relief was achieved in 7/30 patients (23.3%). Nine patients (30.0%) had recurrence of the synovial cyst requiring repeat rupture and 6 patients (20.0%) required surgical intervention for cyst removal. A Wilcoxon signed-rank test demonstrated that the difference in numeric pain rating scale scores before and after the procedure was statistically significant (P < 0.0001). The average pain reduction was 71.2%. No complications were reported. Limitations: The results are limited by the retrospective nature of the data collection and the lack of detailed information regarding patients’ functional improvement. Conclusions: Rupture of percutaneous lumbar synovial cysts in patients with lumbar radiculopathy was associated with immediate relief of radicular symptoms. In 80% of the patients, synovial cyst rupture eliminated the need for surgical interventions over the measured term. This minimally invasive procedure helps relieve pain in a subset of a patient population associated with these characteristics and is useful for management of this condition. Cyst expansion and failure to rupture with possible neuronal compression are the potential complications of this procedure. This complication did not occur in the study population. Key words: Fluoroscopically guided lumbar synovial cyst rupture, lumbar synovial cyst, lumbar zygapophyseal joint cyst, nonsurgical intervention, radiculopathy, spondylosis

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Hemilaminoplasty for the treatment of lumbar intraspinal synovial cysts (LISCs) and literature review

Cited by 15 publications

References 45 publications

Synovial cysts of the spine: long-term follow-up after surgical treatment of 141 cases in a single-center series and comprehensive literature review of 2900 degenerative spinal cysts

Synovial cysts of the spine: long-term follow-up after surgical treatment of 141 cases in a single-center series and comprehensive literature review of 2900 degenerative spinal cysts

Intraspinal Epidural Hematoma Caused By Acupuncture Mimicking An Intraspinal Synovial Cyst: A Case Report

Outcome of Percutaneous Lumbar Synovial Cyst Rupture in Patients with Lumbar Radiculopathy

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Hemilaminoplasty for the treatment of lumbar intraspinal synovial cysts (LISCs) and literature review

Cited by 15 publications

References 45 publications

Synovial cysts of the spine: long-term follow-up after surgical treatment of 141 cases in a single-center series and comprehensive literature review of 2900 degenerative spinal cysts

Synovial cysts of the spine: long-term follow-up after surgical treatment of 141 cases in a single-center series and comprehensive literature review of 2900 degenerative spinal cysts

Intraspinal Epidural Hematoma Caused By Acupuncture Mimicking An Intraspinal Synovial Cyst: A Case Report&nbsp;

Outcome of Percutaneous Lumbar Synovial Cyst Rupture in Patients with Lumbar Radiculopathy

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Intraspinal Epidural Hematoma Caused By Acupuncture Mimicking An Intraspinal Synovial Cyst: A Case Report