[Results after resection of juxta-facet-cysts - Which role does a segmental instability play?]

This study demonstrates the results after operative treatment of patients suffering from a lumbar Juxta-Facet-Cyst. We point out diagnostical aspects, possible concomitant problems and deriving therapeutical consequences. Between 01. 01. 1998 and 31. 03. 2001 9 patients were operated on a synovial cyst or a ganglion of the facet joint at our department. 5 patients were female, 4 patients male with a mean age of 61 (45-70) years. The average clinical and radiological follow up was 11 (5-18) months postoperatively. The clinical examination revealed in 5 out of 9 patients a sensible deficit, in 3 out of 9 patients motoric disturbances. There was no positive sign of Lasegue. The resection of the cyst or ganglion was performed in all cases via a dorsal approach. 8 patients underwent for a spinal stenosis and/or an existing instability a laminectomy and a spondylodesis with an internal fixateur. The histological findings showed a synovial cyst in 6 cases and a ganglion cyst in 3 cases. At the follow up all preoperative sensible or motorical deficits had resolved. Juxta-Facet-Cysts are discovered in some cases intraoperatively by chance, the radiological methods (CT, MRT) are especially in case of a concomitant spinal stenosis uncertain. During all operations, which are performed for a spinal stenosis, one should look for a cyst. The resection of the cyst leads to good functional results, a possible instability should by addressed by a spondylodesis.