BackgroundBenign spinal cysts are relatively common, but can cause significant pain. However, consensus regarding the best method for treating these cysts has not been established. We aimed to examine the usefulness of epiduroscopic neural laser decompression (ENLD), a novel percutaneous treatment, for treating lumbo-sacral cysts.MethodsTen patients (6 men, 4 women; mean age 45.5 years) with benign lumbo-sacral cysts underwent ENLD. The lumbo-sacral cysts were caused by multiple pathophysiologies and displayed different characteristics. Cysts were evaluated using a recorded epiduroscopic procedure video, magnetic resonance imaging (MRI), and electronic medical records. In all patients, MRI identified cysts with well-defined margins that were compressing the nerves in the lumbo-sacral region and were associated with the pain symptoms of the patients. Retrospectively, we reviewed a series of consecutive patients who underwent surgery (two with discal cysts, four with facet cysts, and four with Tarlov cysts). Low back/leg pain was evaluated using a 1–10 visual analog scale. Functional improvement was evaluated using Oswestry Disability Index scores. Outcomes were evaluated pre- and post-operatively and 1 year post-surgery.ResultsPatients were examined between May 2016 and August 2017. Average pain scores improved from 4.7 pre-surgery to 1.8 post-surgery (low back; p < .001) and from 5.8 pre-surgery to 1.6 post-surgery (leg; p < .001). Disability scores decreased from 27.2% pre-surgery to 14.6% post-surgery.ConclusionCurrently, no standard treatment strategy for symptomatic spinal cysts exists. These results show that ENLD using a Holmium: YAG laser can be useful in treating symptomatic benign spinal cysts.Trial registrationNot applicable as this is a retrospective chart review.

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Pars interarticularis fracture is a common finding in young soccer players with low back pain. Spondylolysis in young adults involves a defect of the pars interarticularis, occurring as a result of repeated hyperextension and rotation. Here, we describe the case of a 26-year-old male elite soccer player who was diagnosed with L3 spondylolysis 2 years previously. He visited Incheon Himchan Hospital again because of low back pain. Radiographs showed consecutive spondylolysis at the L3 and L4 levels. Physicians should be aware that repeated performance of athletic movements, such as those during soccer, might lead to consecutive levels of spondylolysis.