scholarly journals Minimally Invasive Posterior Tubular Microsurgical Approach for the Management of Symptomatic Synovial Cysts of the Lumbar and Cervical Spine

10.14444/8134 ◽  
2021 ◽  
pp. 8134
Author(s):  
José Antonio Soriano Sánchez ◽  
Kai Uwe Lewandrowski ◽  
José Alfonso Franco Jímenez ◽  
Manuel Eduardo Soto Garcia ◽  
Sergio Soriano Solís ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Minimally Invasive ◽  
Microsurgical Approach ◽  
Synovial Cysts

scholarly journals A Staged Treatment of Symptomatic Lumbar Intraspinal Synovial Cysts

2019 ◽  
Vol 5 (22;5) ◽  
pp. E451-E456
Author(s):  
Kyung-Hoon Kim
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedures ◽  
Facet Joint ◽  
University Hospital ◽  
Pain Clinic ◽  
Level Of Evidence ◽  
Endoscopic Surgical Procedures ◽  
Number Of Patients ◽  
Synovial Cysts

Background: Lumbar intraspinal synovial cyst (LISC) refers to a cyst that arises from the zygapophyseal joint capsule of the lumbar spine and contains serous or gelatinous fluid. In cases of LISCs resistant to conservative treatments, various minimally invasive percutaneous spinal techniques (MIPSTs) may be applied prior to open surgery. Objectives: The outcomes of 3-staged MIPSTs for the treatment of symptomatic LISCs resistant to conservative treatments were evaluated. Study Design: An institutional review board approved retrospective chart review. Setting: University hospital inpatients referred to our pain clinic. Methods: Review of charts of all patients who underwent MIPSTs for symptomatic LISCs resistant to conservative treatments during a time period of 13 years at a university hospital pain clinic. Patients with symptomatic LISCs resistant to conservative treatments were treated with 3-staged MIPSTs, including image-guided intraarticular aspiration, cyst distention and rupture, and injection of corticosteroids (ARI), endoscopic cyst enucleation (ECE), and endoscopic superior facetectomy (ESF) by a single pain specialist. A symptom-free period after each intervention was evaluated. Recurrence was defined as the same recurrent symptomatic radicular pain with confirmation of the LISC on magnetic resonance imaging. All patients with a minimum follow-up time of 3 years were included. Results: Of the 40 patients who underwent ARI, 3 patients failed to complete a follow-up and 19 patients (51.4%) who had recurring symptoms received ECE. Ten patients (52.6%) who had rerecurring symptoms after ECE received ESF. There was no recurrence after ESF. Limitations: This retrospective and observational study with a limited number of patients does not represent a high level of evidence. Conclusions: This information provided the recurrence rate after each intervention. Half of the patients who went on to receive ARI experienced recurrence, whereas half of the patients with recurrence who received ECE experienced re-recurrence. ESF treatment resulted in no recurrence within the 3-year study period. Key words: Conservative treatment, endoscopic surgical procedures, facet joint, intraarticular injection, minimally invasive surgical procedures, needle biopsy, nerve root compression, radiculopathy, synovial cysts

scholarly journals CT Guided Aspiration of a Cervical Synovial Cyst

2007 ◽  
Vol 13 (3) ◽  
pp. 295-298 ◽  
Author(s):  
V.J. Kostanian ◽  
M.S. Mathews
Keyword(s):  
Cervical Spine ◽  
Nerve Root ◽  
Symptomatic Relief ◽  
Epidural Injection ◽  
Synovial Cyst ◽  
Joint Space ◽  
Complete Relief ◽  
Ct Guided ◽  
Image Guided ◽  
Synovial Cysts

Synovial cysts are cystic dilations of synovial sheaths with or without anatomical continuity within a joint space that occasionally involve the lumbar spine. Image-guided aspiration has been used successfully in the management of lumbar synovial cysts. Synovial cysts of the cervical spine are rare, tend to present with myelopathic symptoms, and are classically treated using operative intervention. We report a novel approach for cervical synovial cyst aspiration under CT guidance. A 66-year-old woman presented to the clinic complaining of severe pain, tingling, and dysesthesia in her right upper extremity in the C5, C6 and C7 nerve root distribution. MR imaging of her cervical spine showed a synovial cyst within the right C6-C7 neural foramen with significant compression and obliteration of the C7 nerve root. The patient underwent CT-guided aspiration of the cyst using a double needle technique, where one needle was used to open up the epidural space while another aspirated the cyst. This was followed by epidural injection of local anesthetic and steroids. Immediately after injection, the patient experienced complete relief of her right forearm pain, tingling, and dysesthesias. The patient tolerated the procedure well and there were no postprocedure complications. At four year follow-up the patient is free of any symptoms. Image-guided aspiration of cervical synovial cysts is feasible using CT fluoroscopy. Aspiration of these cysts combined with epidural steroid injection can provide long-lasting symptomatic relief in some patients.

Posterior Minimally Invasive Approaches for the Cervical Spine

2007 ◽  
Vol 38 (3) ◽  
pp. 339-349 ◽  
Author(s):  
Vishal C. Gala ◽  
John E. O'Toole ◽  
Jean-Marc Voyadzis ◽  
Richard G. Fessler
Keyword(s):  
Cervical Spine ◽  
Minimally Invasive

scholarly journals Clinical feasibility of minimally invasive cervical laminoplasty

2008 ◽  
Vol 25 (2) ◽  
pp. E3 ◽  
Author(s):  
David M. Benglis ◽  
James D. Guest ◽  
Michael Y. Wang
Keyword(s):  
Cervical Spine ◽  
Minimally Invasive ◽  
Foraminal Stenosis ◽  
Cervical Laminoplasty ◽  
Tissue Destruction ◽  
History Of ◽  
Hospital Stays ◽  
Multiple Levels ◽  
Axial Neck Pain ◽  
Lateral Disc Herniation

Minimally invasive approaches to the cervical spine for lateral disc herniation or foraminal stenosis have recently been described. Lower rates of blood loss, decreased narcotic dependence, and less tissue destruction as well as shorter hospital stays are all advantages of utilizing these techniques. These observations can also be realized with a minimal access approach to cervical laminoplasty. Multiple levels of the cervical spine can be treated from a posterior approach with the potential to decrease the incidences of postoperative axial neck pain and kyphotic deformity. In this report the authors present a concise history of the open laminoplasty technique, provide data from previous cadaveric studies (6 cases) along with recent clinical experience for minimally invasive laminoplasty, and describe the advantages and challenges of this novel procedure.

Minimally Invasive Surgical Treatment of Lumbar Synovial Cysts

Neurosurgery ◽  
2004 ◽  
Vol 54 (1) ◽  
pp. 107-112 ◽  
Author(s):  
Faheem A. Sandhu ◽  
Paul Santiago ◽  
Richard G. Fessler ◽  
Sylvain Palmer
Keyword(s):  
Surgical Treatment ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Surgical Techniques ◽  
Synovial Cyst ◽  
Complete Excision ◽  
Tubular Retractor ◽  
Minimally Invasive Surgical ◽  
Average Patient ◽  
Synovial Cysts

Abstract OBJECTIVE Synovial cysts are a rare cause of lumbar radiculopathy and back pain. Surgical treatment is directed at complete excision of the cyst. We used minimally invasive surgical techniques for a series of patients, to assess the effectiveness of this approach for resection of synovial cysts. METHODS Seventeen patients (10 female and 7 male patients) with presumed synovial cysts, as indicated on magnetic resonance imaging scans, underwent surgical resection with the 18-mm METRx tubular retractor system (Medtronic Sofamor Danek, Memphis, TN). A unilateral approach was used, with either an operating microscope (13 cases) or a magnifying endoscope (4 cases), depending on the preference of the surgeon. Outcomes were reported by using modified MacNab criteria. RESULTS The average patient age was 64 years (range, 46–82 yr). The L4–L5 level was most commonly affected (82% of cases). Grade 1 spondylolisthesis at the level harboring the synovial cyst was observed for 47% of the patients; all cases of spondylolisthesis involved the L4–L5 level. The mean operative time was 97 minutes, and the average blood loss was 35 ml. Excellent or good results were achieved for 94% of the patients. A dural tear that did not violate the arachnoid membrane occurred during surgery for one patient but did not require further treatment. CONCLUSION Synovial cysts can be effectively treated with a tubular retractor system in conjunction with an endoscope or microscope. Use of the tubular retractor minimizes soft-tissue trauma, incision length, blood loss, and disruption of ligamentous and bony structures. This may be particularly significant when synovial cysts are associated with spondylolisthesis, minimizing the risk of progressive instability and the need for fusion.

The impact of minimally invasive cervical spine surgery

2004 ◽  
Vol 1 (1) ◽  
pp. 43-46 ◽  
Author(s):  
Tim E. Adamson
Keyword(s):  
Cervical Spine ◽  
Surgical Technique ◽  
Minimally Invasive ◽  
Cervical Radiculopathy ◽  
Foraminal Stenosis ◽  
Content Type ◽  
Cervical Spine Surgery ◽  
The Impact ◽  
Safe Treatment Option ◽  
Fine Print

✓ Since 1997, cervical endoscopic laminoforaminotomy (CELF) has been an effective and safe treatment option for unilateral cervical radiculopathy secondary to disc herniation or foraminal stenosis. The development of the surgical technique is reviewed and recent outcomes discussed. Its impact is addressed in relation to the patient and surgeon.

Magnetic Resonance Imaging Features of Cervical Spine Intraspinal Extradural Synovial Cysts

2019 ◽  
Vol 70 (4) ◽  
pp. 403-407 ◽  
Author(s):  
Davina Mak ◽  
Alessandro Vidoni ◽  
Steven James ◽  
Munchi Choksey ◽  
David Beale ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cervical Spine ◽  
Lumbar Spine ◽  
Magnetic Resonance ◽  
Incidental Findings ◽  
Case Series ◽  
Imaging Features ◽  
Nerve Root Compression ◽  
Resonance Imaging ◽  
Synovial Cysts

Spinal synovial cysts are relatively uncommon and are most frequently found in the lumbar spine and rarely in the cervical spine. Intraspinal extradural cervical synovial cysts can occur and potentially cause cord/nerve root compression with symptoms of myelopathy/radiculopathy; however, most are asymptomatic and incidental findings. We conducted a literature review and present, to our knowledge, the largest imaging case series and describe the magnetic resonance imaging features of cervical synovial cysts.

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