Korean J Pain.  2015 Oct;28(4):275-279. 10.3344/kjp.2015.28.4.275.

Epiduroscopic Removal of a Lumbar Facet Joint Cyst

• Jin HS
• Bae JY
• In CB
• Choi EJ
• Lee PB
• Nahm FS

• KMID: 2151670
• DOI: http://doi.org/10.3344/kjp.2015.28.4.275

Abstract

Facet joint synovial cysts are usually associated with osteoarthritis of the adjacent facet joint and/or spondylolisthesis. In between the conservative and operative ends of the treatment spectrum lie minimally invasive techniques such as cyst rupture using epiduroscopy. In this report, we describe an 82-year-old male patient presenting with low back pain radiating to his lower left extremity and associated paresthesia. Magnetic resonance imaging of the lumbar spine revealed a synovial cyst at left L4/5 facet joint. Using epiduroscopy, the cyst was mechanically ruptured by popping it with the tip of the scope. The patient remained symptom-free at his successive visits until 12 months after the procedure, and was opened for desired follow up.

Keyword

Cyst; Epiduroscopy; Low back pain; Minimally invasive procedures; Therapy; Zygapophyseal joint

MeSH Terms

Aged, 80 and over
Extremities
Follow-Up Studies
Humans
Low Back Pain
Magnetic Resonance Imaging
Male
Osteoarthritis
Paresthesia
Rupture
Spine
Spondylolisthesis
Synovial Cyst
Zygapophyseal Joint*

Figure

• 

  Fig. 1 Intraspinal facet joint cyst located at the left L4/5 facet area. The size of the cyst was 5 × 6 × 13 mm.

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  Fig. 2 Epiduroscope was inserted toward the facet cyst. (A) Schematic image, (B) fluoroscopic image. The tip of the epiduroscope is located near the facet joint.

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  Fig. 3 Epiduroscopic view of the facet cyst. (A) An inflamed, reddish cystic mass is observed. (B) After removal of the cyst.

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