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Transforaminal Full-Endoscopic Lumbar Foraminotomy Under Local Anesthesia for L5/S1 Adjacent Segment Foraminal Stenosis
Published on: October 17, 2025
Far lateral extraforaminal facet cyst causing L5 radiculopathy
Michihiko Manabe1, Minoru Doita, Masaho Yoshikawa
1Department of Orthopedic Surgery, Kanebo Memorial Hospital, Japan.
Journal of Spinal Disorders & Techniques
|August 8, 2006
Summary
Symptomatic synovial cysts in the lumbar spine are rare, especially those outside the spinal canal. This case highlights a far lateral extraforaminal synovial cyst causing lumbar radiculopathy, successfully treated with surgery.
Area of Science:
- Neurosurgery
- Spinal Surgery
- Radiology
Background:
- Synovial cysts of the lumbar spine are typically intraspinal extradural masses near facet joints.
- Symptomatic synovial cysts predominantly occur within the spinal canal or neural foramen.
- Extraspinal synovial cysts are exceptionally rare, with limited documented cases.
Observation:
- A case of lumbar radiculopathy was attributed to a synovial cyst in the far lateral extraforaminal region.
- This location is unusual for symptomatic synovial cysts, presenting a diagnostic challenge.
Findings:
- Surgical decompression of the L5 nerve root was performed.
- The procedure involved a right isthmectomy and facetectomy with recapping.
- The patient experienced complete pain relief and no motor deficits post-surgery.
Implications:
- Juxtafacet cysts must be considered in the differential diagnosis of extraforaminal space-occupying lesions.
- Recapping isthmectomy and facetectomy are effective surgical techniques for far lateral extraforaminal synovial cysts.
- This case expands the understanding of rare spinal cyst presentations and surgical management.
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