Surgical excision of a Juxtafacet cyst in the lumbar spine: A report of thirteen cases with long-term follow up

Abstract

Context:Juxtafacet cysts of the lumbar spine are extradural degenerative lesions associated with symptoms of lower back pain and radiculopathy. Surgical treatment is indicated when there is failure of conservative measures. Primary spinal fusion at the time of surgical excision of the cyst is a matter of controversy. Few reports have described long-term follow-up for surgical treatment of spinal cysts.Aim:The purpose of this study is to assess the long-term outcome of the surgical excision of a Juxtafacet cyst without spinal fusion.Study Design:This is a retrospective case series study, level IV evidence.Materials and Methods:This is a retrospective case series study on 13 patients with Juxtafacet cysts, who were treated with surgical excision of the cysts without spinal fusion. A questionnaire scoring system was used for evaluation of the surgical outcome.Results:The study was conducted on 13 patients, seven females (54%) and six males (46%), their age ranging from 38 to 69 years, with a mean age of 52 (±9.93 STD) years. The mean duration of the symptoms was 10.5 (±6.22 STD) months. All patients got benefit from surgery, with six excellent (46%), six good (46%), and one fair outcome (8%), with no surgery-related complications. The mean follow-up period of the patients at the time of this study was 4.2 years (±1.43 STD).Conclusion:Long-term follow-up for surgical excision of symptomatic Juxtafacet cysts without spinal fusion revealed excellent to good results in 92% of the patients, with a satisfaction rate of 80% (±8.41 STD).

Lumbar Intraforaminal Synovial Cyst in Young Adulthood: Case Report and Review of the Literature

“…12 Painful radiculopathy, which may be unilateral or bilateral, is reported in 57 to 100% of the cases. 3,5,19,20,22,26 Other symptoms like neurogenic claudication, sensory loss, motor weakness, and cauda equina Fig. 1 Magnetic resonance imaging revealed a 1.5-cm intraspinal synovial cyst originating from the left L4-L5 facet joint with low intensity on T1weighted images (C) and hyperintensity on T2-weighted images (B), lying in the spinal canal at the L5 vertebral body level and extending into the neural foramen (A).…”

“…Intraspinal synovial cysts are reported with increasing frequency in the literature but continue to be an uncommon cause of radicular pain. 3 4 5 24 The term lumbar intraspinal synovial cysts refers to cysts that arise from the zygapophyseal joint capsule of the lumbar spine. They are included in the term juxtafacet cyst , which also encompasses ganglion cysts and was introduced by Kao et al in 1974.…”

“…Increased motion seems to have a role in many cysts, and the role of repetitive microtrauma is debated by many authors. 3 4 5 6 Both synovial and ganglion cyst have similar clinical and radiographic features and are considered as an extrusion of the synovium through a capsular defect from degenerative or unstable facet joint. 6 7 8 9 In the last decade, improved imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI) have resulted in increased reporting, diagnostic yield, and treatment options of spinal synovial cysts.…”

Neural Foraminal Lesions: An Imaging Overview

“…These generally occur in the context of degenerated facet joints and thus are also referred to as juxta‐articular or juxtafacet cysts (JFCs). The etiology of these synovial and ganglion cysts is relatively unknown but is thought to be due to postsurgical changes or repetitive microtrauma [27,28]. As such, JFCs are almost always seen in the older population and very rarely seen in adolescence and young adulthood.…”

Interlaminar stabilization and decompression for the treatment of bilateral juxtafacet cysts: Case report and literature review

“…Articular cysts were first described by Aberk von Gruker during an autopsy procedure in 1880 [1] and in 1885 Baker described pathologic cysts adjacent to articulations [2]. The term “juxtafacet cyst” (JFC) was first utilized by Kao et al in 1974 to properly name both synovial and ganglion cysts adjacent to the periarticular connective tissue of the facet joints along with cysts that arise from or into the ligamentum flavum [3].…”