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Published on: February 9, 2024
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Percutaneous Epidural Neuroplasty for Symptomatic Lumbar Juxtafacet Cysts
Juneyoung Heo1, Hyung-Ki Park2, Ji-Hoon Baek3
1Joint & Arthritis Research, Department of Neurosurgery, Himchan Hospital, Seoul 21337, Republic of Korea.
Medicina (Kaunas, Lithuania)
|July 27, 2024
Summary
Percutaneous neuroplasty offers a better success rate for juxtafacet cysts than non-surgical options. However, severe spinal stenosis, L4-L5 cysts, or diabetes increase the risk of recurrence and subsequent surgery.
Area of Science:
- Neurosurgery
- Interventional Radiology
Background:
- Juxtafacet cysts, encompassing synovial cysts and ganglion pseudocysts, often necessitate surgical intervention due to limited efficacy of conservative treatments.
- Complete surgical excision is typically the primary treatment for symptomatic lumbar juxtafacet cysts.
Purpose of the Study:
- To retrospectively evaluate the clinical outcomes of percutaneous epidural neuroplasty for patients with symptomatic lumbar juxtafacet cysts.
- To identify factors influencing the success and recurrence rates of this minimally invasive procedure.
Main Methods:
- A retrospective review of 34 patients with symptomatic lumbar juxtafacet cysts treated between January 2010 and September 2023.
- Inclusion criteria: failure of at least 6 weeks of conservative management.
- Follow-up included medical history, neurological examinations, and pain assessment using the Visual Analog Scale (VAS).
Main Results:
- Immediate pain relief (VAS ≤ 3) was observed in all patients post-neuroplasty.
- 11% of patients experienced eventual pain recurrence requiring surgery.
- Severe spinal stenosis (Schizas grade C or higher) was associated with poor outcomes and a higher likelihood of requiring surgery, irrespective of cyst size.
- Cyst location at L4-L5 and the presence of diabetes mellitus significantly increased the probability of future surgery (p=0.003).
Conclusions:
- Percutaneous neuroplasty demonstrates superior success rates compared to other non-surgical treatments for lumbar juxtafacet cysts.
- Factors such as severe spinal stenosis, L4-L5 cyst location, and diabetes mellitus are predictive of recurrence and the need for subsequent surgical intervention.
