C S Banning1, W E Thorell, L G Leibrock. 1. Section of Neurosurgery, Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.
Abstract
STUDY DESIGN: Retrospective review of patients who underwent lumbar juxtafacet cyst resection with questionnaire follow-up. OBJECTIVES: Determine the long-term outcome after resection of lumbar juxtafacet cysts. SUMMARY OF BACKGROUND DATA: Juxtafacet cysts are uncommon causes of radicular pain and are often associated with significant spinal degenerative disease. Previous studies have not focused on the outcome of patients who have undergone resection. METHODS: Charts of 29 patients who underwent lumbar juxtafacet resection were reviewed and an outcomes questionnaire was sent to each. RESULTS: Thirty-three lumbar juxtafacet cysts were resected from 29 patients. Cysts, 31 (94%) from facets and 2 (6%) from the ligamentum flavum, most commonly arose at the L4-L5 level (51%). Twelve patients (41%) were found to have some degree of spondylolisthesis before surgery, while 26 patients (90%) had facet arthropathy. Two patients (7%) underwent concurrent resection and fusion. Recurrence occurred in 3%. Three patients (9%) had subsequent lumbar spine operations, including 2 fusions (6%). Incidental durotomy was the most common surgical complication occurring in 3 cases (9%). Twenty-four patients (83%) responded to follow-up questionnaire or phone interview. Mean length of follow-up was 24 months (4-64 months). Twenty patients (83%) reported improvement in pain, and 16 (67%) reported an improved level of function. All respondents reported some degree of improvement in their condition after surgery. CONCLUSIONS: Juxtafacet cysts are an uncommon cause of radiculopathy. Surgical resection is the treatment of choice with low rates of complications, recurrences, and residual complaints.
STUDY DESIGN: Retrospective review of patients who underwent lumbar juxtafacet cyst resection with questionnaire follow-up. OBJECTIVES: Determine the long-term outcome after resection of lumbar juxtafacet cysts. SUMMARY OF BACKGROUND DATA: Juxtafacet cysts are uncommon causes of radicular pain and are often associated with significant spinal degenerative disease. Previous studies have not focused on the outcome of patients who have undergone resection. METHODS: Charts of 29 patients who underwent lumbar juxtafacet resection were reviewed and an outcomes questionnaire was sent to each. RESULTS: Thirty-three lumbar juxtafacet cysts were resected from 29 patients. Cysts, 31 (94%) from facets and 2 (6%) from the ligamentum flavum, most commonly arose at the L4-L5 level (51%). Twelve patients (41%) were found to have some degree of spondylolisthesis before surgery, while 26 patients (90%) had facet arthropathy. Two patients (7%) underwent concurrent resection and fusion. Recurrence occurred in 3%. Three patients (9%) had subsequent lumbar spine operations, including 2 fusions (6%). Incidental durotomy was the most common surgical complication occurring in 3 cases (9%). Twenty-four patients (83%) responded to follow-up questionnaire or phone interview. Mean length of follow-up was 24 months (4-64 months). Twenty patients (83%) reported improvement in pain, and 16 (67%) reported an improved level of function. All respondents reported some degree of improvement in their condition after surgery. CONCLUSIONS:Juxtafacet cysts are an uncommon cause of radiculopathy. Surgical resection is the treatment of choice with low rates of complications, recurrences, and residual complaints.
Authors: A Landi; N Marotta; R Tarantino; A G Ruggeri; M Cappelletti; A Ramieri; M Domenicucci; R Delfini Journal: Neurosurg Rev Date: 2011-10-19 Impact factor: 3.042