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Fluoroscopically Guided Facet Cyst Rupture: Rate of Conversion to Surgery and Risk Factor Analysis
Joshua Bell1, Manminder Bhatia1, Michael M Hadeed1
1Departments of Orthopaedic Surgery.
Clinical Spine Surgery
|February 26, 2021
Summary
Fluoroscopically guided facet cyst rupture is a viable treatment, but predicting surgical conversion is difficult. Less than one-third of patients required surgery after this minimally invasive procedure.
Area of Science:
- Neurosurgery
- Radiology
- Spine Surgery
Background:
- Facet joint cysts can cause pain and neurological deficits.
- Percutaneous fluoroscopic cyst rupture is a minimally invasive treatment option.
- Predictors for successful rupture versus surgical decompression remain unclear.
Purpose of the Study:
- To identify clinical, radiologic, and procedural factors associated with conversion to surgery after fluoroscopically guided facet cyst rupture.
Main Methods:
- Retrospective case series of 45 patients.
- Evaluated rate of conversion to surgery after percutaneous cyst rupture.
- Analyzed clinical, radiologic, and procedural variables for risk factors.
Main Results:
- 29% of patients underwent surgery after cyst rupture (average 95 days).
- 38% of surgically treated patients had decompression and fusion.
- No specific factors reliably predicted failure of percutaneous treatment.
Conclusions:
- Fluoroscopic facet cyst rupture can be definitive treatment for many patients.
- Predicting which patients will need surgery post-rupture is challenging.
- Continue offering percutaneous rupture as a nonoperative option when indicated.
