Pierluigi Vergara1, Christopher Yusuf Akhunbay-Fudge2, Mark Robert Kotter3, Rodney John Charles Laing2. 1. Department of Neurosurgery, Addenbrooke's Hospital, Cambridge University Hospital, Cambridge, United Kingdom. Electronic address: spinalneuro@gmail.com. 2. Department of Neurosurgery, Addenbrooke's Hospital, Cambridge University Hospital, Cambridge, United Kingdom. 3. Department of Neurosurgery, Addenbrooke's Hospital, Cambridge University Hospital, Cambridge, United Kingdom; Academic Neurosurgery Unit, Department of Clinical Neuroscience & Wellcome Trust MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom.
Abstract
OBJECTIVE: Lumbar synovial cysts are relatively infrequent. Historically, these benign lesions have been treated with open excision, sometimes associated with fusion. The aim of this study is to compare minimally invasive surgery (MIS) with open surgery (OS) for the treatment of lumbar synovial cysts. METHODS: This was a retrospective review of patients who underwent minimally invasive or open excision of lumbar synovial cysts. Clinical outcomes, recurrence rate, and surgical complications were compared in the 2 groups. RESULTS: A total of 37 cases were identified, of which 24 were MIS and 13 were OS. MIS was significantly more effective in improving leg pain and radicular symptoms. There was no statistical difference between the 2 groups with regard to improvements of back pain and neurogenic claudication. Postoperative length of hospital stay and postoperative pain were significantly reduced in the MIS group (15 hours vs. 24 hours and 0.9/10 vs. 4.7/10 respectively, P < 0.5). There were no statistical differences in duration of surgery, intra- or postoperative complications, no recurrence of cyst in either of the 2 groups, and no patients required fusion at a later stage. CONCLUSIONS: In this study, MIS for the treatment of lumbar synovial cysts appears to be more effective than OS in relieving radicular symptoms. Furthermore, MIS is better tolerated by patients and is potentially cost saving for the Health Service, due to the reduction in hospital stay and the reduced requirement for painkillers.
OBJECTIVE: Lumbar synovial cysts are relatively infrequent. Historically, these benign lesions have been treated with open excision, sometimes associated with fusion. The aim of this study is to compare minimally invasive surgery (MIS) with open surgery (OS) for the treatment of lumbar synovial cysts. METHODS: This was a retrospective review of patients who underwent minimally invasive or open excision of lumbar synovial cysts. Clinical outcomes, recurrence rate, and surgical complications were compared in the 2 groups. RESULTS: A total of 37 cases were identified, of which 24 were MIS and 13 were OS. MIS was significantly more effective in improving leg pain and radicular symptoms. There was no statistical difference between the 2 groups with regard to improvements of back pain and neurogenic claudication. Postoperative length of hospital stay and postoperative pain were significantly reduced in the MIS group (15 hours vs. 24 hours and 0.9/10 vs. 4.7/10 respectively, P < 0.5). There were no statistical differences in duration of surgery, intra- or postoperative complications, no recurrence of cyst in either of the 2 groups, and no patients required fusion at a later stage. CONCLUSIONS: In this study, MIS for the treatment of lumbar synovial cysts appears to be more effective than OS in relieving radicular symptoms. Furthermore, MIS is better tolerated by patients and is potentially cost saving for the Health Service, due to the reduction in hospital stay and the reduced requirement for painkillers.
Authors: José Antonio Soriano Sánchez; Kai Uwe Lewandrowski; José Alfonso Franco Jímenez; Manuel Eduardo Soto Garcia; Sergio Soriano Solís; Manuel Rodríguez García; Oscar Sanchéz Escandón; José Alberto Israel Romero Rangel Journal: Int J Spine Surg Date: 2021-09-22
Authors: Andrew S Chung; Alexander Ballatori; Brandon Ortega; Elliot Min; Blake Formanek; John Liu; Patrick Hsieh; Raymond Hah; Jeffrey C Wang; Zorica Buser Journal: Global Spine J Date: 2020-09-25