Siu Kevin C, Stoodley Marcus A
Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Neurosurgery Unit, Suite 201, Level 2, 2 Technology Place, Macquarie University, NSW 2109, Australia.
J Clin Neurosci. 2018 Dec;58:113-116. doi: 10.1016/j.jocn.2018.09.013. Epub 2018 Oct 16.
Lumbar synovial facet joint cysts cause nerve root compression and radiculopathy. Excision of these cysts is often performed for patients with significant symptoms. There is uncertainty regarding the need for performing a concomitant arthrodesis to prevent spinal instability. This study was performed to assess the rate of postoperative spinal instability with patients undergoing laminectomy without fusion for treatment of lumbar facet joint cysts. Patients who had received a decompressive laminectomy for excision of lumbar spinal cyst(s) without fusion from 2000 to 2015 were reviewed. Their progress was monitored over a 15 year period (2000-2015). SF-12 health surveys were completed at each clinic appointment. Patients were also contacted via phone and mail to assess their postoperative quality of life and to determine whether any further spinal surgery was performed. Forty-six patients were studied with an average follow up of 43 months (1 month-13 years). Two patients had subsequent spinal surgery, neither of which was a fusion. The mean preoperative SF-12 scores were 28 for physical function and 44 for mental function, while the final postoperative follow up score was 33 for physical function and 50 for mental function. Lumbar spinal facet joint cyst excision can be performed by laminectomy without fusion. The rate of subsequent fusion surgery is low.
腰椎滑膜小关节囊肿可导致神经根受压和神经根病。对于有明显症状的患者，常进行这些囊肿的切除术。关于是否需要同时进行关节融合术以防止脊柱不稳定，目前尚不确定。本研究旨在评估接受椎板切除术而不进行融合治疗腰椎小关节囊肿的患者术后脊柱不稳定的发生率。回顾了2000年至2015年期间因切除腰椎囊肿而接受减压椎板切除术且未进行融合的患者。在15年期间（2000 - 2015年）对他们的病情进展进行监测。每次门诊预约时均完成SF - 12健康调查。还通过电话和邮件与患者联系，以评估他们术后的生活质量，并确定是否进行了任何进一步的脊柱手术。对46例患者进行了研究，平均随访43个月（1个月至13年）。两名患者随后接受了脊柱手术，但均非融合手术。术前SF - 12身体功能平均评分为28分，心理功能评分为44分，而术后最终随访身体功能评分为33分，心理功能评分为50分。腰椎小关节囊肿切除术可通过不融合的椎板切除术进行。后续融合手术的发生率较低。
