Endoscopic Surgical Treatment of Lumbar Synovial Cyst.

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Endoscopic Surgical Treatment of Lumbar Synovial Cyst.

World Neurosurg. 2017 Feb 26;:

Authors: Oertel JM, Burkhardt BW

Abstract
BACKGROUND: Lumbar synovial cysts (LSC) are an uncommon cause of radiculopathy and back pain. The open surgical treatment is associated with extensive bone resection and muscle trauma. The endoscopic tubular assisted LSC resection has not been described in detail. Here the authors assessed the effectiveness of this technique for LSC resection.
METHODS: Eleven patients (4 female and 7 male patients) were operated on via an ipsilateral approach for resection of LSC using an endoscopic tubular retractor system. Preoperative magnetic resonance image (MRI) was evaluated for signs of degeneration and instability. At follow-up a standardized questionnaire including Oswestry disability index (ODI), and functional outcome according to MacNab criteria were conducted. Additionally, a personal examination with particular reference to back and leg pain was performed.
RESULTS: The mean follow-up was 10.5 months. Preoperatively, spondylolisthesis Grade 1 was noted in four patients (36.4%), ten patients had bilateral facet joint effusion (90.9%). At follow-up ten patients reported to be free of leg pain (90.9%), eight patients reported to have no back pain (72.7%), ten patients had full motor strength (90.9%), and nine patients had no sensory deficit (81.8%). Nine patients reported to have excellent or good clinical outcome (81.8%). The mean ODI was 4.7%. None of the patients developed new mechanical low back pain or required subsequent fusion procedure.
CONCLUSION: Endoscopic tubular assisted procedure is a safe procedure to treat LSC. It offers complete resection of LSC and achieves good clinical outcome by preserving the muscle, ligamentous and bony structures, which prevents delayed instability.

PMID: 28249826 [PubMed - as supplied by publisher]

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