• PLIF is one of the surgical techniques for spinal arthrodesis. • Treatment indications are degenerative disease or instability following trauma, tumour, or infection. • Screw loosening is a frequent complication that can occur after surgery. • Percutaneous facet consolidation under dual guidance seems to be a feasible technique. • The procedure is performed under local anaesthesia using a minimally invasive approach.
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.
The combination of a new device and dual guidance (computed tomography [CT] and fluoroscopy) is similar to other percutaneous devices in achieving a mechanical decompression of the disc. The difference, however, is that the target of the decompression with the current technique is the herniated disc itself. The goal of this combined technique is to create a space, an “olive” around the probe, allowing a decrease in pressure inside the hernia. Percutaneous discectomy under combined CT and fluoroscopic guidance is a minimally invasive spine surgery that should be considered as an alternative to surgery in properly selected patients.
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