Symptomatic Lumbar Facet Synovial Cysts: Clinical Outcomes Following Percutaneous CT–Guided Cyst Rupture with Intra-articular Steroid Injection

Haider, Steffen J.; Na, Nu R.; Eskey, Clifford J.; Fried, Jessica G.; Ring, N J; Bao, Mike H.; Pastel, David A.

doi:10.1016/j.jvir.2017.04.021

Cited by 15 publications

(9 citation statements)

References 24 publications

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“…There have been reports in the literature that image guided percutanous steroid injection into facet cyst may result in regression and resolution of the cyst both clinically and radiologically [23,24]. In a retrospective report of a 44 consecutive patients with symptomatic lumbar facet cyst received primary treatment with CT-guided synovial cyst rupture with intra-articular steroid injection reported improvement in pain medications, numeric rating scale, Oswestry Disability Index, and 12-item short form health survey (SF-12 PCS) [25].…”

Section: Discussionmentioning

confidence: 99%

Lumbar Facet Cyst as a Rare Cause of L5 Radiculopathy: A Case Report

Habsi

Ghafri

Elsaid

et al. 2020

Case Rep Orthop Res

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Section: Discussionmentioning

confidence: 99%

Lumbar Facet Cyst as a Rare Cause of L5 Radiculopathy: A Case Report

Habsi

Ghafri

Elsaid

et al. 2020

Case Rep Orthop Res

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“…Surgical procedures have shown favorable outcomes, but neurological deterioration and sequelae of laminectomy have also been reported [ 7 ]. Fluoroscopic and CT-guided rupture have an 84% success rate, but 25% of the patients undergo subsequent surgeries due to incomplete cyst decompression during the original procedure [ 8 ]. The trans-foraminal approach has been attempted in some cases, but this procedure can only be applied in patients with intact foramen without senile changes.…”

Section: Discussionmentioning

confidence: 99%

“…Open procedures for treating benign cysts include (1) laminectomy for cyst decompression and nerve root resection [ 2 – 4 ], (2) laminoplasty and cyst fenestration [ 5 ], (3) incision and cyst drainage with plication of cyst [ 6 ], (4) and lumbo-peritoneal CSF shunting [ 7 ]. Percutaneous procedures for addressing benign cysts include (1) computed tomography (CT)-guided cyst rupture [ 8 , 9 ], (2) fluoroscopic fenestration and injections [ 10 ], and (3) trans-foraminal approach and cyst removal or fenestration [ 11 ]. However, these surgical methods have several important drawbacks, including the possibility of triggering neurological deficits, technical difficulty, and possible complications such as instability of the spine.…”

Section: Introductionmentioning

confidence: 99%

A novel technique for managing symptomatic spinal cysts using epiduroscopic neural laser decompression: technical note and preliminary results

et al. 2018

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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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“…Therefore, patients, especially the elderly and those with medical comorbidities can benefit from fluoroscopy or CT-guided percutaneous procedures (6,7) such as percutaneous lumbar facet joint synovial cyst rupture with intra-articular steroid injection (8). Previous studies have reported that fluoroscopy or CT-guided lumbar facet joint synovial cyst rupture was technically successful in 76.7% to 100% of procedures (9)(10)(11), and repeat procedures were required in 20% to 50.5% (9)(10)(11)(12).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Fluoroscopy-Guided Lumbar Facet Joint Synovial Cyst Rupture with Intra-Articular Steroid Injection after Laminectomy

김

이

et al. 2021

J Korean Soc Radiol

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Purpose We retrospectively evaluated the technical success rate and long-term efficacy of fluoroscopy-guided synovial cyst rupture followed by an intra-articular steroid injection at the post-laminectomy lumbar facet. Materials and Methods We selected subjects who had undergone a fluoroscopy-guided synovial cyst rupture with simultaneous intra-articular steroid injection within 6 months of MRI and demonstrated a symptomatic facet joint synovial cyst at the level of a previous lumbar laminectomy. Fourteen patients were enrolled, and we determined whether cyst rupture and symptom improvement were achieved after each procedure. The degrees of symptom improvement were categorized into 4: 1) symptoms improved (30% or more reduction, based on pre-procedural and post-procedural Numerical Pain Rating Scale scores), 2) symptoms not improved, 3) patient underwent surgery after injection, and 4) loss of follow-up. Results The success rate of percutaneous synovial cyst rupture decreased with repeated procedures (62.5% for the first procedure and 0% to 33.3% for additional procedures). However, 80% of the patients had symptom improvement with the procedures, overall. The surgery rate was 14.3% in 14 patients. Conclusion For patients with post-laminectomy symptomatic lumbar facet joint synovial cysts, fluoroscopy-guided synovial cyst rupture with intra-articular steroid injection may be an effective and less invasive treatment before considering a surgical approach.

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Symptomatic Lumbar Facet Synovial Cysts: Clinical Outcomes Following Percutaneous CT–Guided Cyst Rupture with Intra-articular Steroid Injection

Cited by 15 publications

References 24 publications

Lumbar Facet Cyst as a Rare Cause of L5 Radiculopathy: A Case Report

Lumbar Facet Cyst as a Rare Cause of L5 Radiculopathy: A Case Report

A novel technique for managing symptomatic spinal cysts using epiduroscopic neural laser decompression: technical note and preliminary results

Efficacy of Fluoroscopy-Guided Lumbar Facet Joint Synovial Cyst Rupture with Intra-Articular Steroid Injection after Laminectomy

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