Original ArticleMinimally Invasive Tubular Resection of Lumbar Synovial Cysts: Report of 40 Consecutive Cases
Section snippets
Data Collection
Institutional Review Board approval was obtained for this retrospective case series analysis. All patients with a symptomatic lumbar synovial cyst who had undergone a minimally invasive microscopic tubular retractor synovial cyst resection were considered for inclusion. No exclusion criteria were implemented.
Several data points were collected, systematized, and subsequently analyzed. These included patient demographic data, clinical presentation, preoperative workup, preoperative imaging,
Results
Between 1999 and 2015, a total of 40 patients underwent a minimally invasive microscopic tubular retractor synovial cyst resection procedure at our institution. No patients were excluded. All procedures were performed by a single surgeon (B.D.B.). Patient demographic data are summarized in Table 2. The cohort comprised 27 females and 13 males, with a mean age of 65 years (range, 45–82 years). The most common level was L4/L5 (73%; n = 29), followed by L5/S1 (20%; n = 8) and L3/L4 (7%; n = 3).
Overview and Management
The minimally invasive tubular approach for spinal surgery using a tubular retractor was originally described in 1997 for herniated lumbar disc disease.15 We began using this modality for synovial cyst treatment in 1999. The original methodology incorporated endoscopic modalities. Combining the operating microscope with the tubular retractor system, as is done in our practice, offers much improved lighting and magnification.16, 17 There are also significant additional advantages of direct
Conclusions
The minimally invasive microscopic tubular retractor technique to resect juxtafacet lumbar spinal synovial cysts is an effective, safe, and potentially cost-saving procedure. This series represents the largest cohort of patients treated using such a modality with the longest follow-up period reported to date. This surgical procedure can be done with comparable outcomes and complication rates to those of open procedures. In addition, this approach can lead to potentially reduced operating time
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2022, World NeurosurgeryCitation Excerpt :Decompression without fusion is the most common surgical treatment performed for symptomatic LSC.1 However, variety of techniques have been described that include both open and minimally invasive approaches in the form of laminectomy or hemilaminectomy with and without medial facetectomy.3,6,13-17 At our institution, minimally invasive spinal surgery is often the first-line treatment for appropriate cases.
Outcomes and complications following minimally invasive excision of synovial cysts of the lumbar spine: A systematic review and meta-analysis
2021, Clinical Neurology and NeurosurgeryCitation Excerpt :The maximum number of studies published were from the United States of America, and South Korea was the second commonest origin of studies (Fig. 2A). Microscope was used in 11 studies while 9 studies used endoscope for the excision of facet cyst [3,4,10,11,13–30]. Studies using endoscopic technique have been published 2014 onwards (Fig. 2B).
The Results of Microsurgery without Fusion for Lumbar Synovial Cysts: A Case Series of 50 Patients
2020, World NeurosurgeryCitation Excerpt :Medial facetectomy has been proposed as a measure to decrease the relapse rate.1,41 Minimally invasive tubular resection has been advocated by some authors45-48; however, in a large series, the incidence of dural injury was higher (approximately 12.5%).47 Vergara et al.49 compared minimally invasive surgery (MIS) with the open standard in 37 patients with synovial cysts (24 MIS and 13 open standards).
Spinal synovial cysts. A case series and current treatment options
2018, Journal of Clinical NeuroscienceCitation Excerpt :According to some authors, a contralateral approach seems to offer improved results sparing the involved facet joint and also offering a better visualization of the cyst [14,41]. Finally, minimally invasive surgery could be more potent in alleviating radicular symptoms, requires less intraoperative time, reduces the hospitalization period as well as analgesic doses and is more cost-effective in comparison with open surgery [42,43]. Table 1 summarizes current options involved in the treatment of the synovial cysts, whereas Fig. 2 provides an algorithm for the management of such patients.
Minimally Invasive Versus Open Surgery for Lumbar Synovial Cysts
2017, World NeurosurgeryCitation Excerpt :The recurrence rate of synovial cyst in a recent large review of the literature has been shown to be 2.2%.1 Although in our series there was no recurrence in either group, 5 of 6 MIS series in the literature have shown no recurrence,3,5,11-13 and 2 series reported recurrences (2.510 to 4%14). In OS series, the reported recurrence rate varies from 1.8%22 to 3%23 in the nonfusion group and 0% in the fusion group.
Conflict of interest statement: The authors declare that the article content was composed in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.