Abstract
Sabers SR, Ross SR, Grogg BE, Lauder TD. Procedure-based nonsurgical management of
lumbar zygapophyseal joint cyst–induced radicular pain.
Objective
To evaluate the success of fluoroscopically guided, contrast-enhanced lumbar zygapophyseal
joint (Z-joint) aspiration and steroid injection combined with transforaminal epidural
steroid injections (TFESIs) for the treatment of lumbar Z-joint cyst–induced radicular
pain.
Design
Retrospective case series with independent follow-up.
Setting
Institutional, referral center.
Participants
Twenty-three patients referred to a single provider for procedure-based management
of radicular pain believed secondary to lumbar Z-joint cyst. Inclusion criteria consisted
of lumbar radicular pain that was consistent with the level and side of the Z-joint
cyst as a causative lesion.
Interventions
Eighteen patients were treated with a fluoroscopically guided, contrast-enhanced Z-joint
aspiration and steroid injection at the level of the causative cyst coupled with a
fluoroscopically guided, contrast-enhanced TFESI over the level of the presumably
irritated spinal nerve.
Main Outcome Measures
Patient satisfaction, and whether or not surgery was performed.
Results
Fifty percent of patients treated with the procedure had significant long-term benefit
and avoided surgical intervention at an average follow-up of 9.9 months.
Conclusions
Fluoroscopically guided, contrast-enhanced spinal procedures as part of an aggressive
nonsurgical treatment program are a safe and effective alternative to surgical intervention
for lumbar Z-joint cyst–induced radicular pain.
Key Words
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References
- Lumbar nerve root compression by synovial cysts of the ligamentum flavum. Report of four cases.J Neurosurg. 1984; 60: 617-620
- Intraspinal synovial cyst simulating spinal stenosis. A case report.Spine. 1986; 11: 487-489
- Lumbar intraspinal extradural ganglion cyst.J Neurosurg. 1968; 29: 168-172
- The appearances of lumbar intraspinal synovial cysts.Clin Radiol. 1991; 44: 397-401
- Lumbar spinal extradural cysts.Am J Surg. 1950; 80: 124-126
- Intraspinal synovial cysts. Magnetic resonance evaluation.Spine. 1990; 16: 740-745
- Intraspinal synovial cysts.Radiology. 1989; 170: 527-530
- Intraspinal synovial cysts.Radiology. 1982; 145: 375-376
- Synovial cysts of the lumbosacral spine.Am J Roentgenol. 1990; 154: 163-166
- Radiologic recognition of symptomatic spinal synovial cysts.Am J Neuroradiol. 1985; 6: 971-973
- Symptomatic intraspinal synovial cysts.Am J Roentgenol. 1987; 149: 105-107
- Intraspinal lumbar synovial cyst.Orthopedics. 1991; 14: 618-620
- Synovial cyst (ganglion) of the lumbar spine simulating extradural mass.Neuroradiology. 1979; 18: 263-268
- Lumbar synovial cysts.Neurosurgery. 1989; 24: 112-115
- Percutaneous aspiration of lumbar facet synovial cyst.Anesthesiology. 1995; 82: 1061-1062
- Lumbar intraspinal synovial and ganglion cysts (facet cysts).Spine. 1995; 20: 80-89
- Gas-containing “ganglion” cyst of lumbar posterior longitudinal ligament at L3. Case report.Spine. 1993; 18: 2528-2532
- Surgical evaluation and management of lumbar synovial cysts.J Neurosurg Spine. 2000; 93: 53-57
- Symptomatic lumbar facet joint synovial cysts.Radiology. 1999; 210: 509-513
- Nonsurgical treatment of zygapophyseal joint cyst–induced radicular pain.Arch Phys Med Rehabil. 2000; 81: 973-977
- Patient satisfaction after circumferential lumbar fusion.Spine. 2000; 25: 722-760
- The North American spine society lumbar spine outcome assessment instrument.Spine. 1996; 21: 741-749
Article info
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the author(s) or on any organization with which the author(s) is/are associated.
Identification
Copyright
© 2005 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
