Our Summary

This research paper looks at a condition called lumbar synovial facet joint cysts, which can cause nerve root compression and radiculopathy (nerve pain). Sometimes, these cysts are removed surgically in patients who have severe symptoms. However, there’s some debate about whether or not an additional procedure, called arthrodesis, should be carried out at the same time to prevent the spine from becoming unstable.

In this study, the researchers investigated what happens when patients have the cysts removed (a procedure called a laminectomy) without having the additional arthrodesis procedure. They looked at patients who had this done between 2000 and 2015, monitoring their progress for up to 15 years. They used surveys and direct contact to assess the patients’ quality of life after surgery and to find out if they needed any more surgery on their spines.

The study included 46 patients, who were followed up for an average of about 3.5 years. Only two of these patients needed more spinal surgery, and neither of these surgeries involved arthrodesis. The patients’ physical and mental health scores (measured using the SF-12 survey) improved after surgery.

The study concludes that it’s possible to perform a laminectomy to remove lumbar spinal facet joint cysts without doing an additional arthrodesis to stabilize the spine. The likelihood of needing further surgery to stabilize the spine is low.

FAQs

  1. What is the purpose of a lumbar synovial facet joint cyst excision?
  2. Is there a high risk of postoperative spinal instability in patients undergoing laminectomy without fusion for lumbar synovial cysts?
  3. How does the excision of lumbar spinal facet joint cysts impact physical and mental function according to SF-12 health surveys?

Doctor’s Tip

A helpful tip a doctor might tell a patient about spinal laminectomy is to follow postoperative instructions closely, including resting and avoiding strenuous activities to allow for proper healing of the spine. It is also important to attend follow-up appointments and communicate any new or worsening symptoms to the medical team. Additionally, maintaining a healthy lifestyle, including regular exercise and maintaining a healthy weight, can help support the healing process and prevent future spine issues.

Suitable For

Patients who are typically recommended spinal laminectomy for excision of lumbar synovial facet joint cysts are those who are experiencing nerve root compression and radiculopathy due to the cysts. These patients may have significant symptoms that are not relieved with conservative treatments. It is important to note that the need for performing a concomitant arthrodesis to prevent spinal instability is uncertain, as the rate of postoperative spinal instability with laminectomy alone is low. Patients who undergo laminectomy for lumbar facet joint cyst excision should be monitored postoperatively for any signs of spinal instability and may require further surgery if necessary.

Timeline

Before spinal laminectomy:

  • Patient experiences symptoms such as nerve root compression and radiculopathy
  • Patient is diagnosed with lumbar synovial facet joint cysts
  • Patient undergoes decompressive laminectomy for excision of cyst(s)

After spinal laminectomy:

  • Patient is monitored for postoperative spinal instability over a 15 year period
  • SF-12 health surveys are completed at clinic appointments
  • Follow-up assessments are conducted via phone and mail to assess quality of life and need for further spinal surgery
  • Average follow-up period is 43 months
  • Two patients undergo subsequent spinal surgery, neither of which is a fusion
  • Overall, patients show improvement in physical and mental function postoperatively
  • Conclusion: Lumbar spinal facet joint cyst excision can be performed by laminectomy without fusion, with a low rate of subsequent fusion surgery.

What to Ask Your Doctor

  1. What is a spinal laminectomy and why is it necessary for treating lumbar facet joint cysts?
  2. What are the potential risks and complications associated with a spinal laminectomy for lumbar facet joint cysts?
  3. How long is the recovery process after a spinal laminectomy for lumbar facet joint cysts?
  4. Will I need physical therapy or rehabilitation after the procedure?
  5. Are there any restrictions on activities or movements I should follow after the surgery?
  6. How will the surgery affect my quality of life and long-term outcomes?
  7. Are there any alternative treatment options to a spinal laminectomy for my condition?
  8. How will you monitor my progress after the surgery?
  9. What is the likelihood of developing spinal instability after a laminectomy for lumbar facet joint cysts?
  10. Are there any factors that may increase my risk of needing further spinal surgery in the future?

Reference

Authors: Siu KC, Stoodley MA. Journal: J Clin Neurosci. 2018 Dec;58:113-116. doi: 10.1016/j.jocn.2018.09.013. Epub 2018 Oct 16. PMID: 30340971