A Systematic Review and Meta-Analysis of Outcomes and Adverse Events for Juxtafacet Cysts Treatment

Abstract

Background: different procedures have been used for the treatment of lumbar juxtafacet cysts (Jfcs). recently, fullendoscopic cyst excision has been suggested as a reasonable alternative. We performed a meta-analysis to assess the overall rates of favorable outcomes and adverse events for each available treatment and determine the outcome and complication rates concerning spine stability.Methods: Multiple databases were searched for English-language studies involving adult patients with lumbar Jfcs who had been followed for more than 6 months. outcomes included the proportion of patients with a satisfactory outcome. adverse events included recurrence and revision rates as well as intraoperative complications. We further stratified the analysis based on the spine's condition (degenerative listhesis vs without degenerative listhesis).Results: a total of 43 studies, including 2226 patients, were identified. over 80% of patients experienced satisfactory improvement after surgical excision but only 66.2% after percutaneous cyst rupture and aspiration. overall, recurrence and revision rates were almost double in patients with preoperative degenerative listhesis at the cyst level, especially in the minimally invasive group (2.1% vs 31.3% and 6.8% vs 13.1%, respectively). the rate of full-endoscopic satisfactory outcomes was approximately 90%, with low rates of adverse events (<2%).Conclusion: We analyzed the outcome and adverse event rates for each kind of available treatment for Jfc. full endoscopy has outcomes and rates of adverse events that overlap with open and minimally invasive approaches.

Decompression with or without Fusion for Lumbar Synovial Cysts—A Systematic Review and Meta-Analysis

“…It is crucial to understand the symptoms and risk factors associated with lumbar synovial cysts (LSCs) to provide the best possible care for patients who suffer from this condition. Two-thirds of these cysts are located at the L4-L5 level, which is the most mobile lumbar level [ 6 , 7 , 8 ]. The optimal management of symptomatic LSCs is still a matter of debate.…”

“…While there are many different approaches to treating LSCs, the most widely adopted treatment approach is posterior decompression and cyst resection alone. This approach has been shown to have good outcomes in the literature [ 3 , 7 ]. Due to the mentioned association between LSC and spinal micro-instability, lumbar decompression alone has been associated with a risk of cyst recurrence, recurrence of symptoms (especially axial back pain), and establishment of macro-instability, with the need for revision surgery [ 7 , 8 ].…”

“…This approach has been shown to have good outcomes in the literature [ 3 , 7 ]. Due to the mentioned association between LSC and spinal micro-instability, lumbar decompression alone has been associated with a risk of cyst recurrence, recurrence of symptoms (especially axial back pain), and establishment of macro-instability, with the need for revision surgery [ 7 , 8 ]. To avoid these risks, additional lumbar fusion is sometimes performed as part of the same procedure.…”

“…To avoid these risks, additional lumbar fusion is sometimes performed as part of the same procedure. However, this is only necessary in 1–5% of cases [ 6 , 7 ]. Although past publications have suggested that lumbar decompression and fusion (LDF) could outperform lumbar posterior decompression (LPD) [ 8 , 9 ], this problem has never been assessed systematically before.…”

“…This is an important gap in our understanding of LSC treatment. Previous systematic reviews did not stratify data according to different treatment techniques [ 3 ] or incompletely reported comparative data on patients treated with LDF [ 6 , 7 ]. Our study aims to fill this gap by comparing LPD and LDF via a systematic review and meta-analysis of the existing literature.…”