Abstract
PurposeA comprehensive review of the literature in order to analyze data about the success rate of percutaneous resolution of the lumbar facet joint cysts as a conservative management strategy.MethodsA systematic search for relevant articles published during 1980 to May 2014 was performed in several electronic databases by using the specific MeSH terms and keywords. Most relevant data was captured and pooled for the meta-analysis to achieve overall effect size of treatment along with 95% confidence intervals.Results29 studies were included in the meta-analysis. Follow-up duration as mean ± sd (range) was 16±10.2 (5 days to 5.7 years). Overall the satisfactory results (after short- or long-term follow-up) were achieved in 55.8 [49.5, 62.08] % (pooled mean and 95% CI) of the 544 patients subjected to percutaneous lumbar facet joint cyst resolution procedures. 38.67 [33.3, 43.95] % of this population underwent surgery subsequently to achieve durable relief. There existed no linear relationship between the increasing average duration of follow-up period of individual studies and percent satisfaction from the percutaneous resolutions procedure.ConclusionResults shows that the percutaneous cyst resolution procedures have potential to be an alternative to surgical interventions but identification of suitable subjects requires further research.
Highlights
Facet joint cysts of lumbar spine (LFJCs) are benign degenerative outgrowths which are most usually associated with low back pain and radiculopathy
Overall of the 544 subjects included in this meta-analysis, age of the participants as mean 6 sd was 6264.2 (28–87) years and proportion of females in this population was 64%
Major conditions associated with the presence of LFJCs in these patients were lower back pain and radiculopathy, especially lower extremity radiculopathy
Summary
Facet joint cysts of lumbar spine (LFJCs) are benign degenerative outgrowths which are most usually associated with low back pain and radiculopathy. The synovial cysts have vascularized lining filled with xanthochromic fluid and have communication with facet joint while the ganglion cysts are covered by fibrocartilagenous capsule filled with proteinaceous and gelatinous material and do not communicate with joint [2]. These cysts can arise because of the chronic hypermobility of the spinal segments leading to increased and more frequent loading of the zygapophyseal joint (Z-joint; a synovial joint). The LFJCs are associated with spinal stenosis, nerve root compression, neurogenic claudication and many other neurological disturbances by encroaching the local foramen [8,9]
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