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Decompressive laminectomy without fusion for lumbar facet joint cysts

  • Kevin C. Siu
    Affiliations
    Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Neurosurgery Unit, Suite 201, Level 2, 2 Technology Place, Macquarie University, NSW 2109, Australia
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  • Marcus A. Stoodley
    Correspondence
    Corresponding author at: Neurosurgery Unit, Suite 201, Level 2, The Australian School of Advanced Medicine, 2 Technology Place, Macquarie University, NSW 2109, Australia.
    Affiliations
    Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Neurosurgery Unit, Suite 201, Level 2, 2 Technology Place, Macquarie University, NSW 2109, Australia
    Search for articles by this author
Published:October 16, 2018DOI:https://doi.org/10.1016/j.jocn.2018.09.013

      Highlights

      • Lumbar facet joint cysts are an uncommon cause of nerve root compression.
      • Surgical excision is the preferred treatment for symptomatic lumbar synovial cysts.
      • Controversy exists around the need for fusion when excising lumbar synovial cysts.
      • Preoperative grade 1 spondylolisthesis is not an indication for spinal fusion.
      • Lumbar facet joint cyst excision can be safely performed without fusion.

      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.

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