Successful treatment of symptomatic facet joint synovial cysts using C-arm fluoroscopy-guided percutaneous aspiration: report of two cases.

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.