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Brief Report

Intraspinal Lumbar Juxtaarticular Cyst Treatment through CT-Guided Percutaneus Induced Rupture Results in a Favorable Patient Outcome

1
Department of Neurosurgery, Donauisar Klinikum Deggendorf, Perlasbergerstrasse 41, 94469 Deggendorf, Germany
2
Department of Neurosurgery, University Hospital Duesseldorf, Moorenstrasse 5, 40225 Duesseldorf, Germany
*
Author to whom correspondence should be addressed.
Clin. Pract. 2016, 6(4), 866; https://doi.org/10.4081/cp.2016.866
Submission received: 23 June 2016 / Revised: 10 October 2016 / Accepted: 11 October 2016 / Published: 24 November 2016

Abstract

Juxta-articular cysts are synovial cysts originating from the facet joints or the flava ligaments. If they grow intra-spinally they can compress nervous structures and cause a variety of symptoms. Micro-neurosurgery is usually the treatment of choice. Alternatively to surgical treatment the cyst can be approached and treated with a CT guided percutaneous injection inducing rupture. After fulfilling strict selection criteria twenty patients (25% of all treated lumbar synovial cyst patients), were treated minimally invasive by this method from 2010–2016. The facet joint was punctured under CT guidance and a mixture of a local anesthetic and contrast liquid was injected until the cyst was blasted. The mean follow-up period was 1.1 years (range 2 weeks–5 years). Fifteen of twenty procedures were successful and cyst rupture was confirmed by CTscans. Twelve of these fifteen patients experienced a significant improvement of their symptoms and needed no further intervention or surgical procedure up until now, three patients showed no clinical improvement and were treated surgically within one week after cyst rupture. In five patients it was technically not possible to rupture the cyst. These patients were treated microsurgically by cyst resection and dynamic stabilization or fusion procedures. The percutaneus rupture of juxtaarticular cysts has fewer risks and is cost effective compared to microsurgical resection. It may be an alternative to surgical treatment for a selected group of patients. However there are some limitations to the procedure though, such as difficult patient selection, unpredictable outcome or technical problems due to highly degenerated facet joints.
Keywords: synovial cyst; microsurgical decompression; CT-guided cyst rupture synovial cyst; microsurgical decompression; CT-guided cyst rupture

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MDPI and ACS Style

Kursumovic, A.; Bostelmann, R.; Gollwitzer, M.; Rath, S.; Steiger, H.J.; Petridis, A.K. Intraspinal Lumbar Juxtaarticular Cyst Treatment through CT-Guided Percutaneus Induced Rupture Results in a Favorable Patient Outcome. Clin. Pract. 2016, 6, 866. https://doi.org/10.4081/cp.2016.866

AMA Style

Kursumovic A, Bostelmann R, Gollwitzer M, Rath S, Steiger HJ, Petridis AK. Intraspinal Lumbar Juxtaarticular Cyst Treatment through CT-Guided Percutaneus Induced Rupture Results in a Favorable Patient Outcome. Clinics and Practice. 2016; 6(4):866. https://doi.org/10.4081/cp.2016.866

Chicago/Turabian Style

Kursumovic, Adisa, Richard Bostelmann, Maria Gollwitzer, Stefan Rath, Hans Jakob Steiger, and Athanasios K. Petridis. 2016. "Intraspinal Lumbar Juxtaarticular Cyst Treatment through CT-Guided Percutaneus Induced Rupture Results in a Favorable Patient Outcome" Clinics and Practice 6, no. 4: 866. https://doi.org/10.4081/cp.2016.866

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