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Synovial cyst of lumbar spine and facet joint effusion
Prabin Shrestha1, Satoshi Yamaguchi1, Kirill V Nourski1
1Department of Neurosurgery, University of Iowa Health Care, 200 Hawkins Drive, Iowa City, IA 52242, USA.
Introduction:
Spinal synovial cysts (SC) are often associated with facet joint effusion (FJE). However, there is a paucity of information in the literature regarding their relationship. The main objective of this study was to explore the association between FJE and lumbar SC.
Methods:
We retrospectively analyzed lumbar SC cases. FJE was identified and measured based on T2W magnetic resonance imaging, axial sections. Various aspects of association between lumbar SC and FJE were analyzed.
Results:
A total of 153 lumbar SC cases and 306 facet joints were evaluated with FJE measurement. The mean size of FJE (ipsilateral to cyst) was significantly higher at L4-5 and lower at L1-2 (p = 0.025) and was higher in those with higher body mass index (BMI) > 28 (median value) (p = 0.034). Of 306 facet joints, FJE was significantly bigger in those harboring SC (p = 0.029). Presence of SC was significantly associated with FJE > 1.60 mm (median value) (p = 0.040). There was a significant positive correlation between BMI and FJE (r = 0.252, p = 0.002) in lumbar SC cases. However, FJE was not significant in terms of demography, type of surgery and outcome.
Conclusion:
FJE is a sign of degeneration associated with lumbar SC and is significantly higher at L4-5, where SCs are mostly located. Bigger size of FJE is significantly associated with higher BMI and presence of SC. However, the size of FJE alone is not significant in terms of demography, treatment and surgical outcome. A positive correlation between BMI and FJE in lumbar SC cases suggests a triangular relationship among them.
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