Microsurgical Therapy of Symptomatic Lumbar Juxta Facet Cysts

M. F. Oertel; Y. Ryang; A. Ince; J. M. Gilsbach; V. Rohde

doi:10.1055/s-2003-812501

min - Minimally Invasive Neurosurgery, Table of Contents

Minim Invasive Neurosurg 2003; 46(6): 349-353
DOI: 10.1055/s-2003-812501

Original Article

Microsurgical Therapy of Symptomatic Lumbar Juxta Facet Cysts

M. F. Oertel¹ , Y. Ryang¹ , A. Ince¹ , J. M. Gilsbach¹ , V. Rohde¹

¹Department of Neurosurgery, University Hospital, Aachen University, Aachen, Germany

Abstract

Objective: Symptomatic lumbar juxta facet cysts (ganglion and synovial cysts) (JFC) are uncommon lesions of the spine, causing radiculopathy and low back pain. The authors present their experiences with microsurgically treated JFC. This rare pathology is discussed with special focus on therapeutic concepts and long-term outcome.

Method: The records of 27 patients with symptomatic lumbar JFC were retrospectively reviewed. The clinical data and diagnostic procedures were evaluated. The patient age ranged from 38 to 83 years (mean 61 years). Treatment consisted exclusively of microsurgical excision of the cysts after partial hemilaminectomy. The early surgical results were evaluated 6 weeks after surgery. For assessment of late surgical results (mean follow-up period 70 months), the Finneson and Cooper outcome scale was used.

Results: After 6 weeks, the preoperative symptoms were improved in 25 patients (93 %). Long-time follow-up was available in 23 patients. Good (pain improved and able to function well) to excellent (pain free and able to function well) results were still found in 83 % of the patients. With exception of 2 small asymptomatic dural tears and a slight temporary increase of the preoperative paresis, no surgical complications were encountered. One JFC recurred after 4 months and required re-operation with finally good outcome.

Conclusion: Adequate and definitive treatment in symptomatic JFC consists in microsurgical resection. A partial hemilaminectomy is sufficient for surgical exposure. Excellent long-term outcome can be achieved. Recurrences and surgical complications are rare.

Key words

Juxta facet cyst - synovial cyst - ganglion cyst - microsurgery

Full Text

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M. F. Oertel, M. D.

Department of Neurosurgery · Aachen University · Medical School · University Hospital

Pauwelsstrasse 30

52057 Aachen

Germany

Phone: +49-241-8088480

Fax: +49-241-8082420

Email: mfoertel@ukaachen.de