Clinical characteristics of intraspinal facet cysts following microsurgical bilateral decompression via a unilateral approach for treatment of degenerative lumbar disease

详细信息    查看全文

• 作者：Minori Kato (1)
  Sadahiko Konishi (1)
  Akira Matsumura (1)
  Kazunori Hayashi (1)
  Koji Tamai (1)
  Kosuke Shintani (1)
  Kenichi Kazuki (1)
  Hiroaki Nakamura (2)
  
• 关键词：Decompression microsurgery ; Minimally invasive surgery ; Lumbar spinal stenosis ; Lumbar spine
• 刊名：European Spine Journal
• 出版年：2013
• 出版时间：August 2013
• 年：2013
• 卷：22
• 期：8
• 页码：1750-1757
• 全文大小：508KB
• 参考文献：1. Poletti CE (1995) Central lumbar stenosis caused by ligamentum flavum: unilateral laminotomy for bilateral ligamentectomy: preliminary report of two cases. Neurosurgery 37(2):343-47 CrossRef
  2. McCulloch JA, Young PA (1998) Essentials of spinal microsurgery. Lippincott-Raven, Philadelphia
  3. Spetzger U, Bertalanffy H, Naujokat C et al (1997) Unilateral laminotomy for bilateral decompression of lumbar spinal stenosis. Part I: anatomical and surgical considerations. Acta Neurochir (Wien) 139(5):392-96 CrossRef
  4. Spetzger U, Bertalanffy H, Reinges MH et al (1997) Unilateral laminotomy for bilateral decompression of lumbar spinal stenosis. Part II: clinical experiences. Acta Neurochir (Wien) 139(5):397-03 CrossRef
  5. Weiner BK, Walker M, Brower RS et al (1999) Microdecompression for lumbar spinal canal stenosis. Spine 24(21):2268-272 CrossRef
  6. Toyoda H, Nakamura H, Kato M et al (2011) Clinical outcome of microsurgical bilateral decompression via unilateral approach for lumbar canal stenosis: minimum five-year follow-up. Spine 36(5):410-15
  7. Matsumura A, Namikawa T, Terai H et al (2010) The influence of approach side on facet preservation in microscopic bilateral decompression via a unilateral approach for degenerative lumbar scoliosis. J Neurosurg Spine 13(6):758-65 CrossRef
  8. Sasai K, Umeda M, Maruyama T et al (2008) Microsurgical bilateral decompression via a unilateral approach for lumbar spinal canal stenosis including degenerative spondylolisthesis. J Neurosurg Spine 9(6):554-59 CrossRef
  9. Lyons MK, Atkinson JL, Wharen RE et al (2000) Surgical evaluation and management of lumbar synovial cysts. J Neurosurg 93(1 Suppl):53-7
  10. Wilby MJ, Fraser RD, Vernon-Roberts B et al (2009) The prevalence and pathogenesis of synovial cysts within the ligamentum flavum in patients with lumbar spinal stenosis and radiculopathy. Spine 34(23):2518-524 CrossRef
  11. Doyle AJ, Merrilees M (2004) Synovial cysts of the lumbar facet joints in a symptomatic population prevalence on MRI. Spine 29(8):874-78 CrossRef
  12. Sachdev VP, Savitz MH, Hindi AI et al (1991) Synovial cysts of the lumbar facet joint. Mt Sinai J Med 58(2):125-28
  13. Ikuta K, Tono O, Oga M (2009) Prevalence and clinical features of intraspinal facet cysts after decompression surgery for lumbar spinal stenosis. J Neurosurg Spine 10(6):617-22 CrossRef
  14. Minami N, Morinaga T, Ikeda S et al (2011) Facet cysts after hemi-laminectomy of the lumbar spine. J Spine Res 2(7):1241-243 (in Japanese)
  15. Yone K, Sakou T, Kawauchi Y et al (1996) Indication of fusion for lumbar spinal stenosis in elderly patients and its significance. Spine 21(2):242-48 CrossRef
  16. Hirabayashi K, Miyakawa J, Satomi K et al (1981) Operative results and postoperative progression of ossification among patients with ossification of cervical posterior longitudinal ligament. Spine 6(4):354-64 CrossRef
  17. Boxall D, Bradford DS, Winter RB et al (1979) Management of severe spondylolisthesis in children and adolescents. J Bone Jt Surg Am 61(4):479-95
  18. Kurz LT, Garfin SR, Unger AS et al (1985) Intraspinal synovial cyst causing sciatica. J Bone Jt Surg Am 67(6):865-71
  19. Prestar FJ (1996) Juxta facet cysts of the lumbar spine. Minim Invasive Neurosurg 39(2):45-9 CrossRef
  20. Hsu KY, Zucherman JF, Shea WJ et al (1995) Lumbar intraspinal synovial and ganglion cyst (facet cyst). Ten-year experience in evaluation and treatment. Spine 20(1):80-9 CrossRef
  21. Kusakabe T, Kasama F, Aizawa T et al (2006) Facet cyst in the lumbar spine: radiological and histopathological findings and possible pathogenesis. J Neurosurg Spine 5(5):398-03 CrossRef
  22. Houten JK, Sanderson SP, Cooper PR (2003) Spontaneous regression of symptomatic lumbar synovial cysts. J Neurosurg 99(2 Suppl):235-38
  23. Hemminghytt S, Daniels DL, Williams AL et al (1982) Intraspinal synovial cysts: natural history and diagnosis by CT. Radiology 145(2):375-76
  24. Parlier-Cuau C, Wybier M, Nizard R et al (1999) Symptomatic lumbar facet joint synovial cysts: clinical assessment of facet joint steroid injection after 1 and 6?months and long-term follow-up in 30 patients. Radiology 210(2):509-13
  25. Bjorkengren AG, Kurz LT, Resnick D et al (1987) Symptomatic intraspinal synovial cysts: opacification and treatment by percutaneous injection. Am J Roentgenol 149(1):105-07 CrossRef
  26. Howling SJ, Kessel D (1997) Case report: acute radiculopathy due to a haemorrhagic lumbar synovial cyst. Clin Radiol 52(1):73-4 CrossRef
  27. Knox AM, Fon GT (1991) The appearance of lumbar synovial cysts. Clin Radiol 44(6):397-01 CrossRef
  28. Boviatsis EJ, Stavrinou LC, Kouyialis AT et al (2008) Spinal synovial cysts: pathogenesis, diagnosis and surgical treatment in a series of seven cases and literature review. Eur Spine J 17(6):831-37 CrossRef
  29. Banning CS, Thorell WE, Leibrock LG (2001) Patient outcome after resection of lumbar juxtafacet cysts. Spine 26(8):969-72 CrossRef
  
• 作者单位：Minori Kato (1)
  Sadahiko Konishi (1)
  Akira Matsumura (1)
  Kazunori Hayashi (1)
  Koji Tamai (1)
  Kosuke Shintani (1)
  Kenichi Kazuki (1)
  Hiroaki Nakamura (2)
  
  1. Department of Orthopaedic Surgery, Osaka City General Hospital, 2-13-22, Miyakojimahondori, Miyakojima-ku, Osaka, Japan
  2. Department of Orthopaedic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
  

文摘

Purpose Primary intraspinal facet cysts in the lumbar spine are uncommon, but it is unclear whether cyst incidence increases following decompression surgery and if these cysts negatively impact clinical outcome. We examined the prevalence, clinical characteristics, and the risk factors associated with intraspinal facet cysts after microsurgical bilateral decompression via a unilateral approach (MBDU). Methods We studied 230 patients treated using MBDU for lumbar degenerative disease (133 men and 97 women; mean age 70.3?years). Clinical status, as assessed by the Japanese Orthopedic Association (JOA) score and findings on X-ray and magnetic resonance images, was evaluated prior to surgery and at both 3?months and 1?year after surgery. The prevalence of intraspinal facet cysts was determined and preoperative risk factors were defined by comparing presurgical findings with clinical outcomes. Results Thirty-eight patients (16.5?%) developed intraspinal facet cysts within 1?year postoperatively, and 24 exhibited cysts within 3?months. In 10 patients, the cysts resolved spontaneously 1?year postoperatively. In total, 28 patients (12.2?%) had facet cysts 1?year postoperatively. The mean JOA score of patients with cysts 1?year postoperatively was significantly lower than that of patients without cysts. This poor clinical outcome resulted from low back pain that was not improved by conservative treatment. Most cases with spontaneous cyst disappearance were symptom-free 1?year later. The preoperative risk factors for postoperative intraspinal facet cyst formation were instability (OR 2.47, P?=?0.26), scoliotic disc wedging (OR 2.23, P?=?0.048), and sagittal imbalance (OR 2.22, P?=?0.045). Conclusions Postoperative intraspinal facet cyst formation is a common cause of poor clinical outcome in patients treated using MBDU.