Microsurgical Treatment of Juxta Facet Cysts of the Lumbar Spine

Deinsberger, R.; Kinn, Elisabeth; Ungersböck, K.

doi:10.1097/01.bsd.0000188660.31212.83

Cited by 40 publications

(41 citation statements)

References 42 publications

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“…Development of a new synovial cyst after surgical removal is reported in the literature but is only rare [8,16,39,42]. Recurrence of a previously removed LISC is reported in 5 (1%) cases.…”

Section: Discussionmentioning

confidence: 99%

Spinal synovial cysts: pathogenesis, diagnosis and surgical treatment in a series of seven cases and literature review

et al. 2008

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This study is designed based on the retrospective analysis of patients treated in the Neurosurgical Department of two major hospitals and review of the literature. The aim of this study is to evaluate the efficacy of surgery and address controversial issues in the treatment of symptomatic lumbar intraspinal synovial cysts. Spinal juxtafacet cysts (synovial and ganglion cysts) are a rare cause of low back and radicular leg pain. Although the relevant reports in the international literature are increasing, the controversy about conservative versus surgical treatment and the need for concomitant fusion still exists. Data from seven patients (age range 58-69 years, mean age 61 years) with low back and radicular leg pain due to a lumbar facet joint cyst were retrospectively analyzed. Demographic data, cyst level, presence of concomitant local pathology, treatment and results of treatment were recorded. A follow-up of at least 6 months (range 6-48 months) was conducted and results were noted. All patients had back pain, while five also experienced unilateral radicular leg pain and one had bilateral leg pain. One patient had neurogenic claudication. MRI identified the cyst and highlighted underlying pathology in all cases. All patients underwent surgical cyst excision. No fusion was performed. Post-operatively, all patients showed a total resolution of symptoms with sustained benefit at final evaluation. Review of the literature revealed a trend towards surgery, as this is correlated to a more favorable outcome compared with conservative treatment. Fusion should be performed on a case-by-case basis only. Surgery is a safe and effective treatment choice in this increasingly appearing ailment. A prospective, randomized trial should clarify issues under debate.

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“…Development of a new synovial cyst after surgical removal is reported in the literature but is only rare [8,16,39,42]. Recurrence of a previously removed LISC is reported in 5 (1%) cases.…”

Section: Discussionmentioning

confidence: 99%

Spinal synovial cysts: pathogenesis, diagnosis and surgical treatment in a series of seven cases and literature review

et al. 2008

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“…Cyst excision only is a sufficient first line of treatment, even though underlying spinal instability remains. 4,6,14,20,26) Controversy continues regarding concomitant spinal fixation, but this definitely has no influence on cyst recurrence or progression of spondylolisthesis. 2,4,14,16,19,23,26) In the case of larger cysts that tend to densely attach to the dura mater, surgeons should be cautious in aggressive resection when attempting to achieve gross total resection, because of the risk of dura mater and nerve root injury.…”

Section: Discussionmentioning

confidence: 99%

“…2,17,19) The most common presenting symptoms are radiculopathy, neurogenic claudication, or cauda equina syndrome, with associated sensory loss and motor weakness, whereas back pain usually precedes radiculopathy. 4,6,14,16,17,19,20,27) Neuroimaging investigations such as MR imaging have been advocated to accurately identify synovial cyst. MR imaging shows synovial cyst as a sharply marginated epidural mass, located posterolateral to the thecal sac near the facet joint, and in lateral recess.…”

Section: Discussionmentioning

confidence: 99%

“…Conservative treatments including percutaneous needle aspiration of the synovial cyst and intra-articular steroid injection have been advocated, but the outcome of surgical excision has been superior to nonsurgical treatment. 2,4,6,9,14,16,17,19,20,26,27) The surgical technique varies depending on the cyst size, local pathology, and adhesion to the dura. Cyst excision only is a sufficient first line of treatment, even though underlying spinal instability remains.…”

Section: Discussionmentioning

confidence: 99%

“…Synovial cyst is usually monoarthritic and is characterized by protrusion of the synovial membrane through defects of the joint capsule due to degeneration, resulting in the formation of a para-articular cavity with synovial fluid collection and a demonstrable communication to a synovial sheath. 2,6,13) Cases of lumbar synovial cysts have been reported, but not involving invasion of the dura mater and mimicking an intradural extramedullary tumor. Indeed, relatively few cases of synovial cyst in the lumbar or cervical spine have been reported.…”

Section: Introductionmentioning

confidence: 99%

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Intradural Invasion of Lumbar Synovial Cyst

Bae

Lee

Kim

et al. 2012

Neurol. Med. Chir.(Tokyo)

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A 63-year-old female presented with a rare case of synovial cyst invading the dura mater and mimicking an intradural extramedullary tumor in the lumbar spine. She underwent posterior lumbar fusion with laminar wire fixation from L3 to S1 levels. She complained of severe pain along the anterolateral thigh in both legs for 1 year. Radiological examinations, including magnetic resonance imaging and computed tomography revealed an intradural extramedullary lesion at the L2-3 level that was compressing the thecal sac. Histological examination confirmed a synovial cyst. Synovial cyst should be considered in the differential diagnosis of an intradural extramedullary mass causing lumbar radiculopathy.

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