Symptomatic lumbar facet joint cysts treated by CT-guided intracystic and intra-articular steroid injections

Amoretti, N.; Huwart, Laurent; Foti, Pauline; Boileau, Pascal; Amoretti, Marie-Eve; Amélie, Pellegrin; Marcy, Pierre-Yves; Hauger, O.

doi:10.1007/s00330-012-2533-z

Cited by 40 publications

(35 citation statements)

References 11 publications

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“…In our center, the cystectomy is performed by percutaneous rupture of the compressing lumbar facet joint cyst by steroid injection both intra-cystic and intra-articular levels. Several studies have shown the efficiency of this technique as an alternative to the aggressive surgical approach and suggest that percutaneous treatment using double injections can spare 75 % of patients from surgery [9,15].…”

Section: Discussionmentioning

confidence: 99%

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Percutaneous Facet Screw Fixation in the Treatment of Symptomatic Recurrent Lumbar Facet Joint Cyst: A New Technique

Amoretti

Gallo

Bertrand

et al. 2015

Cardiovasc Intervent Radiol

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We present a case of percutaneous treatment of symptomatic recurrent lumbar facet joint cyst resistant to all medical treatments including facet joint steroid injection. Percutaneous transfacet fixation was then performed at L4-L5 level with a cannulated screw using CT and fluoroscopy guidance. The procedure time was 30 min. Using the visual analog scale (VAS), pain decreased from 9.5, preoperatively, to 0 after the procedure. At 6-month follow-up, an asymptomatic cystic recurrence was observed, which further reduced at the 1-year follow-up. Pain remained stable (VAS at 0) during all follow-ups. CT- and fluoroscopy-guided percutaneous cyst rupture associated with facet screw fixation could be an alternative to surgery in patients suffering from a symptomatic recurrent lumbar facet joint cyst.

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Section: Discussionmentioning

confidence: 99%

“…In our center, facet joint cyst is usually treated by injecting intra-articular and intra-cystic steroids mixed with contrast medium to achieve rupture of the cyst with a 75 % of satisfactory clinical outcome [9].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Facet Screw Fixation in the Treatment of Symptomatic Recurrent Lumbar Facet Joint Cyst: A New Technique

Amoretti

Gallo

Bertrand

et al. 2015

Cardiovasc Intervent Radiol

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“…1 There are various methods of treatment, starting from microsurgical decompression, 1-4 decompressive laminectomy, 2 hemilaminoplasty, 5 concomitant or subsequent fusion, 6,7 conservative treatment, 2 and CT- or ultrasound guided intra-cystic steroid injections. 8,9 …”

Section: Introductionmentioning

confidence: 99%

“…On the other hand there are a number of reports stating an excellent outcome after CT-guided intracystic and intraarticular steroid injections. 8 One study of 120 patients showed that 54% of patients were satisfied after first intracystic injection, and 20% after a second injection. 8 In sum 75% of patients were satisfied with intracystic injection treatment according to the study.…”

Section: Introductionmentioning

confidence: 99%

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Intraspinal Lumbar Juxtaarticular Cyst Treatment through CT-Guided Percutaneus Induced Rupture Results in a Favorable Patient Outcome

Kursumovic

Bostelmann

Gollwitzer

et al. 2016

Clinics and Practice

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Juxta-articular cysts are synovial cysts originating from the facet joints or the flava ligaments. If they grow intra-spinally they can compress nervous structures and cause a variety of symptoms. Micro-neurosurgery is usually the treatment of choice. Alternatively to surgical treatment the cyst can be approached and treated with a CT guided percutaneous injection inducing rupture. After fulfilling strict selection criteria twenty patients (25% of all treated lumbar synovial cyst patients), were treated minimally invasive by this method from 2010-2016. The facet joint was punctured under CT guidance and a mixture of a local anesthetic and contrast liquid was injected until the cyst was blasted. The mean follow-up period was 1.1 years (range 2 weeks - 5 years).Fifteen of twenty procedures were successful and cyst rupture was confirmed by CT-scans. Twelve of these fifteen patients experienced a significant improvement of their symptoms and needed no further intervention or surgical procedure up until now, three patients showed no clinical improvement and were treated surgically within one week after cyst rupture. In five patients it was technically not possible to rupture the cyst. These patients were treated microsurgically by cyst resection and dynamic stabilization or fusion procedures. The percutaneus rupture of juxtaarticular cysts has fewer risks and is cost effective compared to microsurgical resection. It may be an alternative to surgical treatment for a selected group of patients. However there are some limitations to the procedure though, such as difficult patient selection, unpredictable outcome or technical problems due to highly degenerated facet joints.

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Synovial Cysts of the Facet Joints

Akhaddar

2023

Atlas of Sciatica

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Symptomatic lumbar facet joint cysts treated by CT-guided intracystic and intra-articular steroid injections

Abstract: Lumbar facet joint cysts are a common feature of back and radicular pain. They may be treated effectively by interventional radiologists using CT guidance. Percutaneous treatment using double injections can save surgery in 75% of patients.

Cited by 40 publications

References 11 publications

Percutaneous Facet Screw Fixation in the Treatment of Symptomatic Recurrent Lumbar Facet Joint Cyst: A New Technique

Percutaneous Facet Screw Fixation in the Treatment of Symptomatic Recurrent Lumbar Facet Joint Cyst: A New Technique

Intraspinal Lumbar Juxtaarticular Cyst Treatment through CT-Guided Percutaneus Induced Rupture Results in a Favorable Patient Outcome

Synovial Cysts of the Facet Joints

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