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

2016 ◽  
Vol 22 (5) ◽  
pp. 596-599
Author(s):  
David J Wang ◽  
Stephen P Lownie ◽  
David Pelz ◽  
Sachin Pandey
Keyword(s):  
Facet Joint ◽  
Symptom Relief ◽  
Percutaneous Treatment ◽  
Synovial Cyst ◽  
Neurogenic Claudication ◽  
Novel Approach ◽  
Successful Approach ◽  
Synovial Cysts ◽  
Cyst Rupture ◽  
Lumbar Facet

Spinal synovial cysts are benign protrusions of facet joint capsules caused by degenerative spondylosis, most frequently involving the L4–5 level, and commonly lead to symptoms of back pain, radiculopathy and neurogenic claudication. Although percutaneous treatment via facet joint steroid injection with cyst rupture can provide significant symptom relief, cyst rupture is not always achievable via an indirect trans-facet approach due to limited access from severe degenerative changes. In this case, we describe a successful approach to direct cyst access using a laser-guided navigational software in a patient with severe facet joint osteophytosis. We provide a brief review of literature.

Synovial facet joint cysts after lumbar posterior decompression surgery

2021 ◽  
pp. 1-6
Author(s):  
Yuichiro Morishita ◽  
Ryota Taniguchi ◽  
Osamu Kawano ◽  
Takeshi Maeda
Keyword(s):  
Facet Joint ◽  
Articular Surface ◽  
Synovial Cyst ◽  
Spinal Instability ◽  
Decompression Surgery ◽  
Neutral Position ◽  
Posterior Decompression ◽  
Retrospective Clinical Study ◽  
Synovial Cysts ◽  
Lumbar Facet

OBJECTIVE Numerous studies have reported on synovial facet joint cysts of the spine as a primary lesion. The exact pathogenesis of those cysts is still controversial, but degeneration and destabilization seem to be underlying mechanisms. However, only a few reports have thus far investigated synovial cysts of the spine as postoperative complications of decompression surgery. In this retrospective clinical study, the authors focused on synovial cysts of the lumbar facet joints as complications after lumbar decompression surgery, with the aim of elucidating their pathophysiology. METHODS A total of 326 patients with 384 segments treated with posterior decompression surgery without fusion were included in the study. Of these segments, 107 were surgically decompressed unilaterally and 277 were decompressed bilaterally. After surgery, 18 of the 384 segments developed a complication of symptomatic facet synovial cyst. The anatomical and morphological evaluations of these segments were performed using functional plain radiographs, CT scans, and MR images. RESULTS All of the 18 segments with postoperative lumbar facet synovial cyst were treated with bilateral lumbar posterior decompression. There was no significant radiological lumbar spinal instability in any segments, although 17 of 18 segments demonstrated facet articular spondylotic changes. Moreover, 12 of 18 patients demonstrated lumbar retrolisthesis in the neutral position. CONCLUSIONS Based on the authors’ results, they propose that patients with lumbar degenerative disease who have a potential biomechanical lumbar instability such as disruption of the facet articular surface and hydrarthrosis or lumbar facet tropism might have a high risk for formation of lumbar facet synovial cyst after bilateral posterior decompression surgery.

MR imaging of lumbar facet joint synovial cysts

2000 ◽  
Vol 10 (4) ◽  
pp. 615-623 ◽  
Author(s):  
E. Apostolaki ◽  
A. M. Davies ◽  
N. Evans ◽  
V. N. Cassar-Pullicino
Keyword(s):  
Mr Imaging ◽  
Facet Joint ◽  
Lumbar Facet Joint ◽  
Synovial Cysts ◽  
Lumbar Facet

Synovial cyst of spinal facet

1974 ◽  
Vol 41 (3) ◽  
pp. 372-376 ◽  
Author(s):  
Chun C. Kao ◽  
Stefan S. Winkler ◽  
J. H. Turner
Keyword(s):  
Facet Joint ◽  
Synovial Cyst ◽  
Cervical Disc ◽  
Content Type ◽  
Synovial Cysts ◽  
Extradural Cyst ◽  
Cervical Facet ◽  
Cervical Facet Joint ◽  
Herniated Cervical Disc ◽  
Fine Print

✓The authors report a case in which a true synovial cyst was found attached to a cervical facet joint. The differential diagnosis involving herniated cervical disc as well as other types of extradural cyst is discussed. The anatomically oriented term “juxta-facet cyst” is proposed to include both ganglion and synovial cysts seen in this area.

scholarly journals Surgically Managed Symptomatic Intraspinal Lumbar Facet Synovial Cyst: Outcome of surgical treatment with resection and instrumented posterolateral fusion, a case series.

2021 ◽  
Author(s):  
Lyonel Beaulieu Lalanne ◽  
Facundo Alvarez Lemos ◽  
Roberto Larrondo Carmona ◽  
Juan Ignacio Cirillo Totera ◽  
Andre Beaulieu Montoya ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Retrospective Review ◽  
Symptom Relief ◽  
Case Series ◽  
Synovial Cyst ◽  
Lumbar Region ◽  
Number Of Patients ◽  
Surgical Data ◽  
Synovial Cysts ◽  
Axial Pain

Abstract PURPOSE: There is controversy regarding the treatment of symptomatic synovial cysts (SSC), specifically, the need for a concomitant fusion when surgical resection of the CS is required. We present a retrospective review of a series of patients treated for SSC of the lumbar region during the last 20 years by a single surgeon, analyzing the current available literature. METHODS: Retrospective review. The same surgical technique was applied to all patients. Demographic, clinical, surgical data and synovial cyst recurrence rate were recorded. Postoperative results reported by patients were documented according to the McNab score. RESULTS: 69 subjects, with mean follow-up of 7.4 years. 62% (43) were female, with a mean 57.8 years at the time of surgery. In 91.3% (63), the primary management was conservative for a minimum period of 3 months. All subjects underwent surgery due to the failure of conservative treatment. The segment most operated on was L4-L5 (63.77%). 91.3% (63) of the sample reported excellent and good and 6 subjects (8.6%) fair or poor results. There was no evidence of CS recurrence at the operated level. CONCLUSION: In SSC, it seems that conservative treatment is only effective in a limited number of patients and in the short term. Thus, the recommendation of a surgical indication should proceed as soon as the conservative management fails to result in significant symptom relief. Based on our results, we recommend, together with the resection of the cyst, the instrumentation of the segment to avoid its recurrence and the management of axial pain.

Microsurgical Resection of a Lumbar Synovial Cyst: 2-Dimensional Operative Video

2021 ◽  
Author(s):  
Brian J A Gill ◽  
Kyle Lindsey McCormick ◽  
Paul C McCormick
Keyword(s):  
Degenerative Spondylolisthesis ◽  
Synovial Cyst ◽  
Radicular Pain ◽  
Surgical Anatomy ◽  
Neurogenic Claudication ◽  
Presenting Symptoms ◽  
Patient Consent ◽  
Synovial Cysts ◽  
Cyst Recurrence ◽  
Microsurgical Resection

Abstract Lumbar spine synovial cysts develop from degenerated zygapophyseal joints. Symptomatic patients present with radicular pain and weakness or neurogenic claudication.1 In the absence of significant concomitant degenerative spondylolisthesis, symptomatic patients can be managed with a laminectomy and microsurgical resection of the cyst, without the need for instrumented fusion.2,3 In this video, we present the microsurgical resection of a left-sided L4-5 synovial cyst in a 68-yr-old man with radicular pain refractory to conservative management. The radiographical features, relevant surgical anatomy, and salient operative steps are reviewed, and strategies for preventing cyst recurrence are emphasized. There were no complications, the postoperative course was unremarkable, and the patient was discharged on postoperative day 1 with significant improvement in his presenting symptoms. No identifying information is present, and patient consent was obtained for the procedure and for publishing the material included in this video.

Retrospective review of percutaneous synovial cyst ruptures: increased thickness of the T2 hypointense rim on post-rupture MRI may be associated with need for subsequent surgery

2016 ◽  
Vol 9 (8) ◽  
pp. 00.2-00 ◽  
Author(s):  
Benjamin Y M Kwan ◽  
Fateme Salehi ◽  
Sang Jia ◽  
Stuart McGregor ◽  
Neil Duggal ◽  
...  
Keyword(s):  
Retrospective Chart Review ◽  
Synovial Cyst ◽  
Leg Pain ◽  
Surgical Removal ◽  
Mri Scan ◽  
Technical Success Rate ◽  
Significant Difference ◽  
Synovial Cysts ◽  
Operative Notes ◽  
Cyst Rupture

ObjectiveTo analyze MRI characteristics of lumbar facet synovial cysts and distinguish those requiring subsequent surgical management for recurrence, after percutaneous synovial cyst rupture.Methods and materialsRetrospective chart review conducted in patients undergoing percutaneous synovial cyst rupture between February 2012 and April 2015. Pre- and post-percutaneous rupture procedure MRI spine studies were serially reviewed. Synovial cyst sizes, T1 and T2 signal characteristics and changes therein, T2 hypointense (or ‘dark rim’) thickness and change, and changes in the complexity of cyst signals were compared. Operative notes for patients who underwent subsequent surgical removal of recurrent synovial cysts were reviewed.Results24 patients received 41 percutaneous synovial cyst rupture procedures, with a technical success rate of 82.9%. There was a significant difference in the mean increased thickness of the T2 hypointense rim on the first post-rupture MRI scan (p=0.0411) between patients requiring subsequent surgery and those who did not. There was a significant difference in the average sizes of synovial cysts before the procedure (p=0.0483) in those requiring subsequent surgery and those who did not. Five complications were noted (12.2%), mostly involving leg pain or weakness. Of the nine patients who underwent subsequent surgery post-synovial cyst rupture, six of the surgeries had recorded difficulty pertaining to scarring and/or adherence of the cyst to dura.ConclusionsA larger increase in thickness of the T2 hypointense rim on the first post-rupture MRI scan and a larger synovial cyst size were associated with the need for subsequent surgical resection.

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