J Korean Orthop Assoc.  2017 Feb;52(1):65-72. 10.4055/jkoa.2017.52.1.65.

Radiologic Features and Surgical Outcome of Juxtafacet Cyst Associated with Degenerative Lumbar Disease

• Kim WJ
• Chang SH
• Yang HY
• Kwon WJ
• Sung HI
• Park KH
• Choy WS

• KMID: 2369573
• DOI: http://doi.org/10.4055/jkoa.2017.52.1.65

Abstract

PURPOSE
The purpose of this study was to evaluate the radiologic features of juxtafacet cyst and determine the correlation between these features and clinical outcome.
MATERIALS AND METHODS
We analyzed a total of 23 patients. The degree of facet joint degeneration was classified using the Fujiwara method. The facet joint angles were measured with an magnetic resonance imaging to determine whether there was a difference between the cystic lesion that was occupied and the cystic lesion that was not occupied. Disc degeneration was measured by the Pfirrmann classification method. The clinical result was evaluated using the Oswestry disability index score and visual analogue scale.
RESULTS
The L4-5 level of juxtafacet cyst was mostly affected, as found in previous studies. Facet joint arthritis was more severe within the side with the cystic lesion. Significant correlation was found between disc degeneration and juxtafacet joint cyst. All patients underwent wide decompression and fusion. Clinical result was excellent. No patients had signs of recurrence during the follow-up periods.
CONCLUSION
Juxtafacet cyst has a significant correlation with facet joint degeneration. Therefore, aggressive surgical treatment"”not just simple cyst excision"”should be considered as the treatment option for juxtafacet cyst associated with degenerative lumbar disease.

Keyword

juxtafacet cyst; degenerative lumbar disease; wide decompression and fusion

MeSH Terms

Arthritis
Classification
Decompression
Follow-Up Studies
Humans
Intervertebral Disc Degeneration
Joints
Magnetic Resonance Imaging
Methods
Recurrence
Zygapophyseal Joint

Figure

• 

  Figure 1 Four grades of facet joint osteoarthritis on magnetic resonance imaging (grade classification according to the Fujiwara methods). (A) Grade 1: normal facet joint. (B) Grade 2: narrowed both facet joint space and left facet joint shows mild osteophyte. (C) Grade 3: narrowed both facet joint space and right facet joint shows moderate osteopytes. (D) Grade 4: not only marked osteophytes but also sclerotic changes are observed within both facet joint.

• 

  Figure 2 Measurement of facet joint angle.

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