Oertel M F, Ryang Y, Ince A, Gilsbach J M, Rohde V
Department of Neurosurgery, Aachen University Medical School, University Hospital, Pauwelsstrasse 30, 52057 Aachen, Germany.
Minim Invasive Neurosurg. 2003 Dec;46(6):349-53. doi: 10.1055/s-2003-812501.
Symptomatic lumbar juxta facet cysts (ganglion and synovial cysts) (JFC) are uncommon lesions of the spine, causing radiculopathy and low back pain. The authors present their experiences with microsurgically treated JFC. This rare pathology is discussed with special focus on therapeutic concepts and long-term outcome.
The records of 27 patients with symptomatic lumbar JFC were retrospectively reviewed. The clinical data and diagnostic procedures were evaluated. The patient age ranged from 38 to 83 years (mean 61 years). Treatment consisted exclusively of microsurgical excision of the cysts after partial hemilaminectomy. The early surgical results were evaluated 6 weeks after surgery. For assessment of late surgical results (mean follow-up period 70 months), the Finneson and Cooper outcome scale was used.
After 6 weeks, the preoperative symptoms were improved in 25 patients (93 %). Long-time follow-up was available in 23 patients. Good (pain improved and able to function well) to excellent (pain free and able to function well) results were still found in 83 % of the patients. With exception of 2 small asymptomatic dural tears and a slight temporary increase of the preoperative paresis, no surgical complications were encountered. One JFC recurred after 4 months and required re-operation with finally good outcome.
Adequate and definitive treatment in symptomatic JFC consists in microsurgical resection. A partial hemilaminectomy is sufficient for surgical exposure. Excellent long-term outcome can be achieved. Recurrences and surgical complications are rare.
有症状的腰椎小关节旁囊肿（神经节囊肿和滑膜囊肿）（JFC）是脊柱的罕见病变，可导致神经根病和腰痛。作者介绍了他们显微手术治疗JFC的经验。对这种罕见的病理情况进行了讨论，特别关注治疗理念和长期结果。
回顾性分析27例有症状的腰椎JFC患者的病历。评估临床资料和诊断程序。患者年龄在38至83岁之间（平均61岁）。治疗仅包括在部分半椎板切除术后显微手术切除囊肿。术后6周评估早期手术结果。为评估晚期手术结果（平均随访期70个月），使用芬内森和库珀结果量表。
6周后，25例患者（93%）术前症状得到改善。23例患者获得长期随访。83%的患者仍有良好（疼痛改善且功能良好）至优秀（无疼痛且功能良好）的结果。除2例小的无症状硬脊膜撕裂和术前轻瘫略有短暂加重外，未发生手术并发症。1例JFC在4个月后复发，需再次手术，最终结果良好。
有症状的JFC的充分和确定性治疗包括显微手术切除。部分半椎板切除术足以进行手术暴露。可实现优异的长期结果。复发和手术并发症很少见。
