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Spinal synovial cysts: pathogenesis, diagnosis and surgical treatment in a series of seven cases and literature review

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An Erratum to this article was published on 15 May 2008

Abstract

This study is designed based on the retrospective analysis of patients treated in the Neurosurgical Department of two major hospitals and review of the literature. The aim of this study is to evaluate the efficacy of surgery and address controversial issues in the treatment of symptomatic lumbar intraspinal synovial cysts. Spinal juxtafacet cysts (synovial and ganglion cysts) are a rare cause of low back and radicular leg pain. Although the relevant reports in the international literature are increasing, the controversy about conservative versus surgical treatment and the need for concomitant fusion still exists. Data from seven patients (age range 58–69 years, mean age 61 years) with low back and radicular leg pain due to a lumbar facet joint cyst were retrospectively analyzed. Demographic data, cyst level, presence of concomitant local pathology, treatment and results of treatment were recorded. A follow-up of at least 6 months (range 6–48 months) was conducted and results were noted. All patients had back pain, while five also experienced unilateral radicular leg pain and one had bilateral leg pain. One patient had neurogenic claudication. MRI identified the cyst and highlighted underlying pathology in all cases. All patients underwent surgical cyst excision. No fusion was performed. Post-operatively, all patients showed a total resolution of symptoms with sustained benefit at final evaluation. Review of the literature revealed a trend towards surgery, as this is correlated to a more favorable outcome compared with conservative treatment. Fusion should be performed on a case-by-case basis only. Surgery is a safe and effective treatment choice in this increasingly appearing ailment. A prospective, randomized trial should clarify issues under debate.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Athens Medical School, Evangelismos General Hospital, 61 Ipsilantou Street, Athens, 115 21, Greece

    Efstathios J. Boviatsis, Lampis C. Staurinou, Andreas T. Kouyialis, Marios Themistokleous & Damianos E. Sakas

  2. Hellenic Center for Neurosurgical Research “Petros Kokkalis”, Athens, Greece

    Efstathios J. Boviatsis, Lampis C. Staurinou, Andreas T. Kouyialis, Marios Themistokleous & Damianos E. Sakas

  3. Department of Radiology, “Ag. Sofia” Children’s Hospital, Athens, Greece

    Maria M. Gavra

  4. Department of Neurosurgery, AHEPA General Hospital, Thessaloniki, Greece

    Pantelis C. Stavrinou & Panayiotis Selviaridis

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  1. Efstathios J. Boviatsis
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  2. Lampis C. Staurinou
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  3. Andreas T. Kouyialis
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Correspondence to Efstathios J. Boviatsis.

Additional information

An erratum to this article can be found at http://dx.doi.org/10.1007/s00586-008-0673-2

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Boviatsis, E.J., Staurinou, L.C., Kouyialis, A.T. et al. Spinal synovial cysts: pathogenesis, diagnosis and surgical treatment in a series of seven cases and literature review. Eur Spine J 17, 831–837 (2008). https://doi.org/10.1007/s00586-007-0563-z

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  • DOI: https://doi.org/10.1007/s00586-007-0563-z

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