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Juxtafacet Spinal Synovial Cysts.

Abd El-Kader Hel-B - Asian Spine J (2016)

Bottom Line: An excellent or good outcome was considered as satisfactory.All patients included in this study had excellent outcomes as regarding to improvement of all preoperative manifestations and returning to normal daily activities.Only 2 cases developed postoperative transient cerebro-spinal fluid leak and were treated conservatively and improved during the follow up period.

View Article: PubMed Central - PubMed

Affiliation: Neurosurgery, Al-Menoufia University, Al-Menoufia, Egypt.

ABSTRACT

Study design: This was a retrospective study.

Purpose: To study the surgical outcome of synovial cysts of the lumbar spine through posterior laminectomy in combination with transpedicular screw fixation.

Overview of literature: Synovial cysts of the lumbar spine contribute significantly to narrowing of the spinal canal and lateral thecal sac and nerve root compression. Cysts form as a result of arthrotic disruption of the facet joint, leading to degenerative spondylolisthesis in up to 40% of patients.

Methods: Retrospective data from 6 patients, treated during the period of March 2007 to February 2011, were analyzed. All preoperative and postoperative manifestations, extension/flexion radiographs, magnetic resonance imaging, and computed tomography records were reviewed. All underwent surgery for synovial cysts with excision and decompression combined with posterior fixation. The result of surgery was evaluated with Macnab's classification. An excellent or good outcome was considered as satisfactory. Japanese Orthopedic Association Scale was used for evaluation of back pain.

Results: All patients included in this study had excellent outcomes as regarding to improvement of all preoperative manifestations and returning to normal daily activities. Only 2 cases developed postoperative transient cerebro-spinal fluid leak and were treated conservatively and improved during the follow up period.

Conclusions: Although this study included a small number of cases and we could not have statistically significant results, the good outcome of decompression of synovial cysts combined with posterior fixation and fusion encouraged us to recommend this approach for patients with juxtafacet synovial cysts.

No MeSH data available.


Related in: MedlinePlus

(A, B) Postoperative X-ray (lateral, antero-posterior view) after laminectomy, excision of the cyst and transpedicular screw fixation.
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Figure 6: (A, B) Postoperative X-ray (lateral, antero-posterior view) after laminectomy, excision of the cyst and transpedicular screw fixation.

Mentions: The clinical symptoms were assessed at 3, 6, and 12 months post discharge from the hospital through the Japanese Orthopedic Association Scale (JOA). The JOA score was determined via direct questioning to assess subjective symptoms, clinical signs and presence of any restrictions on daily activities. Radiological follow-up: immediate postoperative plain X-rays was done to confirm the accurate position of pedicular screws and other X-rays were done at the end of the follow-up (Fig. 6). An independent radiologist was invited to evaluate the status based on radiographic study. Surgical outcome was classified using Macnab's classification: excellent, complete relief of back/leg pain; good, occasional pain in back/leg; fair, some improvement in back/leg pain with occasional use of pain medications; poor, little or no change in pain or pain worse than before the surgery and a regular use of pain medications [7].


Juxtafacet Spinal Synovial Cysts.

Abd El-Kader Hel-B - Asian Spine J (2016)

(A, B) Postoperative X-ray (lateral, antero-posterior view) after laminectomy, excision of the cyst and transpedicular screw fixation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4764539&req=5

Figure 6: (A, B) Postoperative X-ray (lateral, antero-posterior view) after laminectomy, excision of the cyst and transpedicular screw fixation.
Mentions: The clinical symptoms were assessed at 3, 6, and 12 months post discharge from the hospital through the Japanese Orthopedic Association Scale (JOA). The JOA score was determined via direct questioning to assess subjective symptoms, clinical signs and presence of any restrictions on daily activities. Radiological follow-up: immediate postoperative plain X-rays was done to confirm the accurate position of pedicular screws and other X-rays were done at the end of the follow-up (Fig. 6). An independent radiologist was invited to evaluate the status based on radiographic study. Surgical outcome was classified using Macnab's classification: excellent, complete relief of back/leg pain; good, occasional pain in back/leg; fair, some improvement in back/leg pain with occasional use of pain medications; poor, little or no change in pain or pain worse than before the surgery and a regular use of pain medications [7].

Bottom Line: An excellent or good outcome was considered as satisfactory.All patients included in this study had excellent outcomes as regarding to improvement of all preoperative manifestations and returning to normal daily activities.Only 2 cases developed postoperative transient cerebro-spinal fluid leak and were treated conservatively and improved during the follow up period.

View Article: PubMed Central - PubMed

Affiliation: Neurosurgery, Al-Menoufia University, Al-Menoufia, Egypt.

ABSTRACT

Study design: This was a retrospective study.

Purpose: To study the surgical outcome of synovial cysts of the lumbar spine through posterior laminectomy in combination with transpedicular screw fixation.

Overview of literature: Synovial cysts of the lumbar spine contribute significantly to narrowing of the spinal canal and lateral thecal sac and nerve root compression. Cysts form as a result of arthrotic disruption of the facet joint, leading to degenerative spondylolisthesis in up to 40% of patients.

Methods: Retrospective data from 6 patients, treated during the period of March 2007 to February 2011, were analyzed. All preoperative and postoperative manifestations, extension/flexion radiographs, magnetic resonance imaging, and computed tomography records were reviewed. All underwent surgery for synovial cysts with excision and decompression combined with posterior fixation. The result of surgery was evaluated with Macnab's classification. An excellent or good outcome was considered as satisfactory. Japanese Orthopedic Association Scale was used for evaluation of back pain.

Results: All patients included in this study had excellent outcomes as regarding to improvement of all preoperative manifestations and returning to normal daily activities. Only 2 cases developed postoperative transient cerebro-spinal fluid leak and were treated conservatively and improved during the follow up period.

Conclusions: Although this study included a small number of cases and we could not have statistically significant results, the good outcome of decompression of synovial cysts combined with posterior fixation and fusion encouraged us to recommend this approach for patients with juxtafacet synovial cysts.

No MeSH data available.


Related in: MedlinePlus