Related Experiment Video
Updated: May 29, 2026
The Third Channel-Assisted Unilateral Biportal Endoscopic Technique for Lumbar Spinal Stenosis Combined with Contralateral Disc Herniation
Published on: November 17, 2023
Lumbar juxtafacet cyst resection: the facet sparing contralateral minimally invasive surgical approach
Andrew James1, Ilya Laufer, Karishma Parikh
1Department of Neurosurgery, Brain and Spine Center, Weill Cornell Medical College, New York Presbyterian Hospital, New York, NY 10021, USA. dr.andrew.james.cornell@gmail.com
Study Design:
A retrospective review.
Objective:
To report our approach and results using a contralateral minimally invasive spinal surgical muscle splitting approach that allows visualization of the cyst without extensive removal of the adjacent facet joint.
Summary Of Background Data:
The use of tubular retractors for spinal surgery can potentially minimize tissue injury. Contralateral approaches may be beneficial in visualizing pathology that is located adjacent or under the facet joint. This approach has not been reported previously.
Methods:
Sixteen consecutive patients were treated using this approach using tubular retractors and the operating microscope. A retrospective chart and imaging review was conducted to determine operative and clinical measures. Subsequently, patients were contacted to obtain long-term clinical follow-up.
Results:
Nine patients had an excellent and 5 had a good outcome, with median follow-up of 18 months, 2 patients were lost due to lack of follow-up. The mean operative time was 105 minutes and in all cases the blood loss was <40 mL. No postoperative instability was noted.
Conclusions:
A contralateral approach using a tubular retractor system provides excellent visualization of the facet cyst allowing safe cyst resection and nerve root decompression without compromising the facet joint. Larger case series with longer follow-up are needed to assess stability.
