Decompressive laminectomy without fusion for lumbar facet joint cysts

Abstract

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.