Department of Algology, Acıbadem Maslak Hospital, İstanbul, Türkiye.
Agri. 2024 Jan;36(4):272-275. doi: 10.14744/agri.2022.07742.
Lumbar facet joint synovial cysts are benign degenerative abnormalities of the lumbar spine and can cause lower extremity ra-diculopathy, spinal stenosis, and low back pain. Herein, we report a case with a synovial cyst treated by percutaneous fluoros-copic aspiration via the facet joint. A 46-year-old woman presented to the neurosurgery clinic complaining of a 2-month history of low back pain with left-sided radicular symptoms. Her physical examination was consistent with a left L5 radiculopathy, and MRI confirmed a left L5-S1 facet joint synovial cyst compressing the nerve root. Percutaneous fluoroscopic cyst aspiration via the facet joint was planned. The cyst was aspirated, and a total of 0.2-0.3 cc of fluid was removed. During the aspiration, the patient reported pain relief. Thus, the procedure was completed. An MRI taken after 3 weeks showed that the cyst had become smaller than before, with no evidence of nerve root compression. For 1 year, the patient has had no pain or neurological symptoms. Patients who undergo a fluoroscopic percutaneous rupture by filling of the facet joint cyst typically have successful outcomes. We conclude that aspiration of the facet joint cyst without rupture can also result in the same successful outcome.
腰椎小关节滑膜囊肿是腰椎的良性退行性病变，可引起下肢神经根病、椎管狭窄和腰痛。在此，我们报告一例经关节突关节行经皮荧光透视抽吸治疗的滑膜囊肿。一名 46 岁女性因腰痛伴左侧神经根症状就诊于神经外科门诊，病史 2 个月。她的体格检查符合左侧 L5 神经根病，MRI 证实左侧 L5-S1 关节突关节滑膜囊肿压迫神经根。计划行经关节突关节荧光透视下囊肿抽吸。抽吸囊肿，共抽吸 0.2-0.3 cc 液体。抽吸过程中，患者自述疼痛缓解。因此，手术完成。3 周后的 MRI 显示囊肿较前缩小，无神经根受压证据。1 年来，患者无疼痛或神经症状。通过关节突关节填充行荧光透视经皮破裂的患者通常有良好的疗效。我们得出结论，不破裂抽吸关节突关节囊肿也可以获得相同的良好效果。
