A novel approach to symptomatic lumbar facet joint synovial cyst injection and rupture using iGuide navigational software: A case report and review

Wang, David J.; Lownie, Stephen P.; Pelz, David M.; Pandey, Sachin

doi:10.1177/1591019916653253

Cited by 1 publication

(1 citation statement)

References 8 publications

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“…New methods with the use of navigational software are offering some help here. 20 As stated in the review of Epstein and Baisden there is another problem in the use of cyst injections. The ease of use lead to an immense increase of using and abusing the method of 231% with an increase of total reimbursement from 24 million $ to 175 million $ showing that the method is used too deliberately.…”

Section: Discussionmentioning

confidence: 99%

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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Section: Discussionmentioning

confidence: 99%