Kim Hyeon Tae, Choi Jung Hee, Shin Young Duck, Kim Tae Yul, Lee Joo Yong
Department of Anesthesiology and Pain Medicine, Chungbuk National University Hospital, College of Medicine, Chungbuk National University Chungcheongbuk-do 28644, Korea.
Am J Transl Res. 2022 May 15;14(5):3547-3553. eCollection 2022.
Lumbar facet-joint synovial cysts are an important cause of back pain and radiculopathy. Treatment options for facet-joint synovial cysts include surgical excision, facet-joint steroid injections, and facet-joint cyst aspiration. Although percutaneous facet-joint synovial cyst aspiration is an effective and minimally invasive procedure for treating patients with symptomatic facet-joint synovial cysts, its success rate is known to be low. Here, we report out experience with treating two men using this approach. The men presented with back pain or radiculopathy. In both cases, magnetic resonance imaging showed facet-joint synovial cysts in the lumbar spine at various locations. Depending on the location of the cysts, 2-3 needles and various needle approaches were required for treatment. The facet-joint synovial cysts were aspirated using the intra-articular, interlaminar, or safe triangle approach. After aspiration, both patients experienced immediate improvement in their symptoms, and neither of them relapsed during more than 12 months of follow-up. Percutaneous aspiration of symptomatic facet-joint synovial cysts under fluoroscopic guidance is a treatment option worth considering in patients with facet-joint synovial cysts.
腰椎小关节滑膜囊肿是背痛和神经根病的重要原因。小关节滑膜囊肿的治疗选择包括手术切除、小关节类固醇注射和小关节囊肿抽吸。尽管经皮小关节滑膜囊肿抽吸术是治疗有症状的小关节滑膜囊肿患者的一种有效且微创的方法，但其成功率已知较低。在此，我们报告使用这种方法治疗两名男性患者的经验。这两名男性患者均表现为背痛或神经根病。在这两例病例中，磁共振成像均显示腰椎不同部位存在小关节滑膜囊肿。根据囊肿的位置，治疗需要2至3根针及不同的进针路径。采用关节内、椎板间或安全三角入路对小关节滑膜囊肿进行抽吸。抽吸后，两名患者的症状均立即得到改善，且在超过12个月的随访期间均未复发。在透视引导下经皮抽吸有症状的小关节滑膜囊肿，是小关节滑膜囊肿患者值得考虑的一种治疗选择。
