Department of Orthopaedic Surgery, Duke University Medical Center, Box 2807, 335 Baker House, 200 Trent Drive, Durham, NC, USA.
J Clin Neurosci. 2013 Dec;20(12):1771-3. doi: 10.1016/j.jocn.2012.12.021. Epub 2013 Jul 18.
Facet cysts are a relatively common source of neural compression in the lumbar spine. Open decompression and fusion are frequently used to treat the stenosis and instability associated with this pathology. Recently, anterior lumbar interbody fusion (ALIF) has increased in popularity for the treatment of lumbar degenerative conditions. ALIF may achieve indirect decompression of the neural elements with less surgical morbidity than conventional open approaches. To date, there are no published reports describing the use of indirect decompression or interbody fusion for the treatment of facet cysts. We report a patient who developed an L4-L5 facet cyst secondary to degenerative changes and spondylolisthesis. ALIF with posterior instrumentation was used to address his condition. Six months after surgery, the patient had complete resolution of his symptoms. MRI revealed complete resolution of the facet cyst. This patient provides previously unreported evidence that interbody fusion alone may result in facet cyst resolution. Clinical studies are needed to evaluate if interbody fusion can consistently relieve the symptoms associated with facet cysts without the use of direct decompression.
关节突囊肿是腰椎神经根受压的一个常见原因。开放性减压和融合术常被用于治疗与该病理相关的狭窄和不稳定性。最近，前路腰椎间融合术（ALIF）因其治疗腰椎退行性疾病的优势而越来越受欢迎。ALIF 可实现对神经结构的间接减压，手术并发症较传统开放性手术少。迄今为止，尚无文献报道描述使用间接减压或椎间融合术治疗关节突囊肿。我们报告了 1 例因退行性变和脊椎滑脱导致 L4-L5 关节突囊肿的患者。采用后路内固定的 ALIF 来解决他的病情。术后 6 个月，患者症状完全缓解。MRI 显示关节突囊肿完全消退。该患者提供了之前未报道的证据，表明单纯椎间融合可能导致关节突囊肿消退。需要进行临床研究来评估椎间融合是否可以在不进行直接减压的情况下，持续缓解与关节突囊肿相关的症状。
