C Schulz1, B Danz, S Waldeck, U Kunz, U M Mauer. 1. Abt. Neurochirurgie, Bundeswehrkrankenhaus Ulm, Oberer Eselsberg 40, 89081, Ulm, Deutschland. chr74@gmx.de
Abstract
BACKGROUND: Microsurgical resection is the standard treatment of lumbar juxtafacet cysts. Percutaneous computed tomography (CT) guided destruction of the cyst could be an alternative modality for inoperable patients. Comparative prospective studies for both treatment strategies do not exist. MATERIALS AND METHODS: This study involved a non-randomized, prospective trial on 45 patients suffering from sciatica or claudication caused by lumbar juxtafacet cysts. Of the patients 25 were operated on microsurgically and 20 patients were primarily treated using percutaneous CT-guided cyst destruction. RESULTS: The treatment in both groups was performed without complications in all patients. All patients treated microsurgically were pain-free (mean postoperative interval 27 months) but only 8 out of 20 patients treated percutaneously recovered completely (mean post-treatment interval 24 months). The remaining 12 out of 20 patients showed no relevant improvement and were operated on microsurgically. CONCLUSION: Minimally invasive cyst destruction is not a viable alternative to microsurgical resection considering the long-term outcome, neither in this study nor in the reviewed literature.
BACKGROUND: Microsurgical resection is the standard treatment of lumbar juxtafacet cysts. Percutaneous computed tomography (CT) guided destruction of the cyst could be an alternative modality for inoperable patients. Comparative prospective studies for both treatment strategies do not exist. MATERIALS AND METHODS: This study involved a non-randomized, prospective trial on 45 patients suffering from sciatica or claudication caused by lumbar juxtafacet cysts. Of the patients 25 were operated on microsurgically and 20 patients were primarily treated using percutaneous CT-guided cyst destruction. RESULTS: The treatment in both groups was performed without complications in all patients. All patients treated microsurgically were pain-free (mean postoperative interval 27 months) but only 8 out of 20 patients treated percutaneously recovered completely (mean post-treatment interval 24 months). The remaining 12 out of 20 patients showed no relevant improvement and were operated on microsurgically. CONCLUSION: Minimally invasive cyst destruction is not a viable alternative to microsurgical resection considering the long-term outcome, neither in this study nor in the reviewed literature.
Authors: Ali Bydon; Risheng Xu; Scott L Parker; Matthew J McGirt; Mohamad Bydon; Ziya L Gokaslan; Timothy F Witham Journal: Spine J Date: 2010-05-20 Impact factor: 4.166
Authors: Julia F Martha; Bryan Swaim; David A Wang; David H Kim; James Hill; Rita Bode; Carolyn E Schwartz Journal: Spine J Date: 2009-08-06 Impact factor: 4.166