Outcomes and complications following minimally invasive excision of synovial cysts of the lumbar spine: A systematic review and meta-analysis

Garg, Kanwaljeet; Kasliwal, Manish K.

doi:10.1016/j.clineuro.2021.106667

Cited by 5 publications

(4 citation statements)

References 35 publications

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“…5,8,29,30 (2) Improvements of surgical procedures may help preserve stability after laminectomy and further reduce the needs for subsequent fusions, such as the facet-sparing techniques, 1 cyst location–dependent excision approach, 20 and minimally invasive surgery. 31-35 (3) The known relatively higher complications after LF is most likely due to increased invasiveness and was identified as the top reason for SS in this study. 9,18,20,21 However, technological developments can also be applied to fusion surgeries to reduce complications.…”

Section: Discussionmentioning

confidence: 90%

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Lumbar Synovial Cysts—Should You Fuse or Not?

Gonzalez

Corso

Kothari³

et al. 2022

Neurosurgery

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BACKGROUND:Spinal synovial cysts are lesions that most commonly occur in the lumbar region. The need for an instrumented spinal fusion in addition to lumbar decompression with removal of the synovial cyst is unknown.OBJECTIVE:To test the hypothesis that select patients who underwent decompression with instrumented fusion for lumbar synovial cysts would be less likely to have subsequent surgery (SS) in a 2-year period than patients treated with laminectomy alone.METHODS:This retrospective cohort study was performed using IBM MarketScan Commercial Claims and Encounters Database. Patients who had a lumbar synovial cyst diagnosis and laminectomy surgery with or without fusion surgery were included in this study. Patients were tracked for SS 2 years after surgery. Laminectomy patients were propensity score–matched to laminectomy with fusion (LF) patients using a 2:1 ratio. The log-rank test and Cox regression were used to compare the cumulative incidence of SS between groups.RESULTS:There were 7664 and 1631 patients treated with laminectomy and LF before matching. After matching, there were 2212 laminectomy and 1631 LF patients and patient characteristics were balanced. The 2-year incidence of recurrent SS was 3.1% ([CI]: 2.2%, 4.0%) and 1.7% (95% CI: 0.9%, 2.5%) laminectomy and LF, respectively. Compared with laminectomy, LF had a statistically significant lower risk of recurrent SS (hazard ratio: 0.56 [95% CI: 0.32-0.97]; P-value: .04).CONCLUSION:All patients who had concomitant lumbar fusion showed decreased chance of having a cyst- or noncyst-related recurrence SS when compared with all patients undergoing laminectomy alone, regardless of diagnosis at the time of SS.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Lumbar Synovial Cysts—Should You Fuse or Not?

Gonzalez

Corso

Kothari³

et al. 2022

Neurosurgery

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“…Kim et al ( 14 ) evaluated the clinical outcomes of a three-stage minimally invasive percutaneous technique for lumbar intraspinal synovial cysts and found that endoscopic superior facetectomy resulted in no recurrence within the 3 years follow-up. One meta-analysis revealed no significant differences in outcome or complication rates between microscopic and endoscopic resection for lumbar FJCs ( 13 ). Another meta-analysis showed that full endoscopy could achieve 90% satisfactory outcomes with low rates of adverse events (<2%) better than open and minimally invasive surgeries ( 24 ).…”

Section: Discussionmentioning

confidence: 99%

“…Image-guided intraarticular aspiration, image-guided cyst rupture, image-guided epidural steroid injection, laminotomy, and decompression by microsurgical or traditional open techniques have been reported to be effective in treating symptomatic lumbar FJCs (12)(13)(14)(15)(16). Recently, uniportal full endoscopy (UFE), a minimally invasive technique, has been widely applied to treat lumbar disc herniation, lumbar spinal stenosis, and cervical spondylopathy (17,18).…”

Section: Introductionmentioning

confidence: 99%

Percutaneous uniportal full-endoscopic surgery for treating symptomatic lumbar facet joint cysts under local anesthesia combined with monitored anesthesia care: a preliminary report of eight cases with at least 1 year follow-up

Tan,

Yu,

et al. 2023

Front. Neurol.

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BackgroundLumbar facet joint cysts (FJCs) are a relatively rare clinical pathology that can result in radiculopathy or neurogenic claudication. Various treatments such as percutaneous aspiration and surgery have been reported to have good clinical outcomes. However, few clinical studies have aimed to treat symptomatic lumbar FJCs by using uniportal full-endoscopic (UFE) surgery. This study aimed to investigate the preliminary clinical outcomes of UFE surgery for the treatment of lumbar FJCs under local anesthesia combined with monitored anesthesia care (MAC).MethodsEight patients (five males and three females) with symptomatic lumbar FJCs who underwent UFE surgery under local and MAC anesthesia were enrolled in this study between January 2018 and April 2022. The clinical characteristics, radiological features, operative information, visual analog scale (VAS) score, Oswestry disability index (ODI), and overall outcome rating based on the modified MacNab criteria were retrospectively analyzed.ResultsOf the eight patients, four underwent a transforaminal approach and four underwent an interlaminar approach. Postoperatively, the mean VAS score for leg pain decreased from 6.1 before surgery to 0.6 after surgery, and the ODI decreased from 74.5% to 14.7%. All patients were followed up for more than 1 year, and the good-to-excellent rate based on the modified MacNab criteria remained 100% at the last follow-up. No complications occurred during the follow-up period.ConclusionLumbar FJCs can cause severe radiating leg pain and/or neurogenic claudication due to the dural sac compression and nerve roots. As an alternative treatment, UFE decompression under local and MAC anesthesia may provide effective clinical outcomes for symptomatic lumbar FJCs.

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Synovial Cysts of the Facet Joints

Akhaddar

2023

Atlas of Sciatica

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Outcomes and complications following minimally invasive excision of synovial cysts of the lumbar spine: A systematic review and meta-analysis

Cited by 5 publications

References 35 publications

Lumbar Synovial Cysts—Should You Fuse or Not?

Lumbar Synovial Cysts—Should You Fuse or Not?

Percutaneous uniportal full-endoscopic surgery for treating symptomatic lumbar facet joint cysts under local anesthesia combined with monitored anesthesia care: a preliminary report of eight cases with at least 1 year follow-up

Synovial Cysts of the Facet Joints

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