Patient Outcome After Resection of Lumbar Juxtafacet Cysts

Banning, Chris S.; Thorell, William E.; Leibrock, Lyal G.

doi:10.1097/00007632-200104150-00024

Cited by 90 publications

(76 citation statements)

References 25 publications

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“…1,2,5,12,13,15,20,22 These lesions were usually discovered incidentally during surgery before the advent of CT and MR imaging, but with the increasing use of neuroimaging in the evaluation and management of cases of degenerative disease of the spine, they are commonly seen on preoperative diagnostic studies. Their presence and potential role as a generator of symptoms must be considered.…”

mentioning

confidence: 99%

Diagnosis and management of juxtafacet cysts

Choudhri¹,

Perling²

2006

FOC

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✓ Juxtafacet cysts are lesions that are associated with spinal facet joints. Although these lesions are frequently noted as incidental findings on imaging studies of the spine, they may produce symptoms in some patients. Juxtafacet cysts can mimic herniated discs, resulting in symptoms from focal nerve root and/or spinal cord compression. Some of these lesions are associated with spinal instability, and patients may require spinal fusion to address this underlying disorder. Conservative therapy for symptomatic lesions is often unsuccessful, although there are reports of spontaneous resolution of these cysts as well as the symptoms associated with them. Surgical therapy should be focused on decompression of the lesions causing nerve root compression and the accompanying symptoms, while recognizing that instability requiring fusion may be present in some but not all cases.

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mentioning

confidence: 99%

Diagnosis and management of juxtafacet cysts

Choudhri¹,

Perling²

2006

FOC

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“…Conservative treatment consists of bed rest, analgesics plus anti-inflammatory drugs, physical therapy, bracing, transcutaneous electrical stimulation, epidural or intra-articular steroid injections, and computed tomography-guided fine needle aspiration and arthrography [25][26][27]. Surgical treatments include resection or fusion [28,29]. A treatment regimen for postoperative cysts has not yet been established.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of intraspinal facet cysts following microsurgical bilateral decompression via a unilateral approach for treatment of degenerative lumbar disease

et al. 2013

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Purpose Primary intraspinal facet cysts in the lumbar spine are uncommon, but it is unclear whether cyst incidence increases following decompression surgery and if these cysts negatively impact clinical outcome. We examined the prevalence, clinical characteristics, and the risk factors associated with intraspinal facet cysts after microsurgical bilateral decompression via a unilateral approach (MBDU). Methods We studied 230 patients treated using MBDU for lumbar degenerative disease (133 men and 97 women; mean age 70.3 years). Clinical status, as assessed by the Japanese Orthopedic Association (JOA) score and findings on X-ray and magnetic resonance images, was evaluated prior to surgery and at both 3 months and 1 year after surgery. The prevalence of intraspinal facet cysts was determined and preoperative risk factors were defined by comparing presurgical findings with clinical outcomes. Results Thirty-eight patients (16.5 %) developed intraspinal facet cysts within 1 year postoperatively, and 24 exhibited cysts within 3 months. In 10 patients, the cysts resolved spontaneously 1 year postoperatively. In total, 28 patients (12.2 %) had facet cysts 1 year postoperatively. The mean JOA score of patients with cysts 1 year postoperatively was significantly lower than that of patients without cysts. This poor clinical outcome resulted from low back pain that was not improved by conservative treatment. Most cases with spontaneous cyst disappearance were symptom-free 1 year later. The preoperative risk factors for postoperative intraspinal facet cyst formation were instability (OR 2.47, P = 0.26), scoliotic disc wedging (OR 2.23, P = 0.048), and sagittal imbalance (OR 2.22, P = 0.045). Conclusions Postoperative intraspinal facet cyst formation is a common cause of poor clinical outcome in patients treated using MBDU.

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“…The juxtafacet cyst infection should remain a part of the differential diagnosis for low back pain as their presentation often mimics more common presenting complaints. In the face of a seemingly benign juxtafacet cyst, conservative management is an option but surgical decompression is the most definitive means of treatment [4,6,8,9]. The use of varying amounts of rest, anti-inflammatory agents, and immobilization with a brace has also been described [1].…”

Section: Discussionmentioning

confidence: 99%

“…In the degenerative spine, the prevalence of juxtafacet cyst is a known entity and often associated with trauma and rheumatoid arthritis [1][2][3]. The term ''juxtafacet cysts'' encompasses both synovial cyst, which has a synovial lining membrane and the ganglion cysts having no synovial type lining [3,4]. The process is thought to be related to joint degeneration, escape of synovial fluid and granulation tissue into an extra-articular space.…”

Section: Introductionmentioning

confidence: 99%

“…The first reported instance of intraspinal ganglion cysts was by von Gruker in 1880. Most frequently, they are found at the L4-5 facet joint the most mobile segment of the lumbar spine [3][4][5]. The facet cyst can lead to a mass effect and cause neural compression leading to radiculopathy, neurogenic claudication, and myelopathy or they can extrude into the surrounding soft tissue and seemingly be less consequential [3].…”

Section: Introductionmentioning

confidence: 99%

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Juxtafacet cyst infection

2012

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Purpose In the realm of spinal surgery, infections have multiple etiologies and sites of origin. In this case series, we describe a juxtafacet cyst spinal infection that can often be missed or attributed to common symptomology of benign processes despite florid infection. Methods In rare instances, the juxtafacet cyst may become infected and require direct intervention. This case report attempts to describe the prodrome leading to such a diagnosis and two different ways to manage an infected facet cyst. Results Management of spinal infections varies due to the multiplicity of causes and location of infections. The juxtafacet cyst infection should remain a part of the differential diagnosis for low back pain as their presentation often mimics more common presenting complaints. Conclusions In our two patient presentations, both were diabetics and had remote histories of cancer that necessitated chemotherapy or radiation therapy. They also seemingly had de novo onset of infected juxtafacet cyst. The variety of causes and presentations of spinal infections should heighten the astute surgeon to be suspicious of these entities and thus intervene early with appropriate management.

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Patient Outcome After Resection of Lumbar Juxtafacet Cysts

Abstract: Juxtafacet cysts are an uncommon cause of radiculopathy. Surgical resection is the treatment of choice with low rates of complications, recurrences, and residual complaints.

Cited by 90 publications

References 25 publications

Diagnosis and management of juxtafacet cysts

Diagnosis and management of juxtafacet cysts

Clinical characteristics of intraspinal facet cysts following microsurgical bilateral decompression via a unilateral approach for treatment of degenerative lumbar disease

Juxtafacet cyst infection

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