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Hemilaminoplasty for the treatment of lumbar intraspinal synovial cysts (LISCs) and literature review

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Abstract

Purpose

The present report intended to introduce the hemilaminoplasty technique and evaluate the efficacy of our surgical procedure for LISCs.

Methods

This retrospective study was conducted to analyze the results in 24 LISCs who had undergone our hemilaminoplasty between 2000 and 2012 in two hospitals. All were confirmed by pathological histology and mid- to long-term follow-up had been performed in all cases with a mean of 4.9 years. Using the Japanese Orthopedic Association scoring system (JOA score) and visual analog scale (VAS), symptoms resulting from cyst compression were quantified at various stage for statistical analysis.

Results

The JOA score and VAS of back/leg pain following surgery were improved significantly (P < 0.01). At final follow-up, with normal aging there was a little decrease in JOA score and VAS of back/leg pain, but still significantly improved (P < 0.01). Similarly, mean improvement rate of JOA was 83.5 % at 1 year after surgery while 75.6 % at final visit. Successful bone healing was obtained at a mean of 3.8 months after surgery. No cyst reformation and recurrent back/leg pain were observed around the surgical sites.

Conclusions

These lesions could be regarded as a result of facet arthrosis/instability and repetitive facet minor trauma with herniation of synovium through the defective joint capsule. Improvement in lumbago and leg pain may be a consequence of complete cyst resection via hemilaminoplasty plus partial facetectomy with anatomical reconstruction of the posterior spinal elements.

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References

  1. Vosschulte K, Borger G (1950) The inflammatory processes in sciatica due to inter-vertebral disk hernia. Med Monatsschr 4:371–375

    CAS  PubMed  Google Scholar 

  2. Kao CC, Winkler SS, Turner JH (1974) Synovial cyst of spinal facet. Case report. J Neurosurg 41:372–376

    Article  CAS  PubMed  Google Scholar 

  3. Shah R, Lutz G (2003) Lumbar intraspinal synovial cyst: conservative management and review of the world’s literature. Spine J 3:479–488

    Article  PubMed  Google Scholar 

  4. Ayberk G, Ozveren F, Gok B et al (2008) Lumbar synovial cyst: experience with nine cases. Neurol Med Chir (Tokyo) 48:298–303

    Article  Google Scholar 

  5. Lyons MK et al (2000) Surgical evaluation and management of lumbar synovial cysts: the Mayo Clinic experience. J Neurosurg 93(Suppl):53–57

    CAS  PubMed  Google Scholar 

  6. Boviatsis EJ, Staurinou LC, Kouyialis AT (2008) Spinal synovial cysts: pathogenesis, diagnosis and surgical treatment in a series of seven cases and literature review. Eur Spine J 17(6):831–837

    Article  PubMed  PubMed Central  Google Scholar 

  7. Epstein NE (2004) Lumbar synovial cysts. A review of diagnosis, surgical management and outcome assessment. J Spinal Disord Tech 17:321–325

    Article  PubMed  Google Scholar 

  8. Epstein NE (2004) Lumbar laminectomy for the resection of synovial cysts and co-existing lumbar spinal stenosis or degenerative spondylolisthesis: an outcome study. Spine 29(9):1049–1055

    Article  PubMed  Google Scholar 

  9. Banning CS, Thorell WE, Leibrock LG (2001) Patient outcome after resection of lumbar juxtafacet cysts. Spine 26:969–972

    Article  CAS  PubMed  Google Scholar 

  10. Doyle AJ, Merrilees M (2004) Synovial cysts of the lumbar facet joints in a symptomatic population: prevalence on magnetic resonance imaging. Spine 29:874–878

    Article  PubMed  Google Scholar 

  11. Khan A, Girardi F (2006) Spinal lumbar synovial cysts. Diagnosis and management challenge. Eur Spine J 15:1176–1182

    Article  PubMed  PubMed Central  Google Scholar 

  12. Allen T, Tatli Y, Lutz G (2009) Fluoroscopic percutaneous lumbar zygapophyseal joint cyst rupture: a clinical outcome study. Spine J 9:387–395

    Article  PubMed  Google Scholar 

  13. Xu R, McGirt M, Parker S et al (2010) Factors associated with recurrent back pain and cyst recurrence after surgical resection of one hundred ninety-five synovial cyst: analysis of one hundred sixty-seven consecutive cases. Spine 35:1044–1053

    Article  PubMed  Google Scholar 

  14. Metellus P, Fuentes S, Adetchessi T et al (2006) Retrospective study of 77 patients harbouring lumbar synovial cysts: functional and neurological outcome. Acta Neurochir (Wien) 148:47–54

    Article  CAS  Google Scholar 

  15. Dagain A, Dulou R, Dutertre G et al (2008) Surgical management of synovial cyst of the lumbar spine retrospective study of 52 patients [in French]. Rev Chir Orthop Reparatrice Appar Mot 94:289–296

    Article  CAS  PubMed  Google Scholar 

  16. Bjorkengren AG, Kurz LT, Resnick D et al (1987) Symptomatic intraspinal synovial cysts: opacification and treatment by percutaneous injection. AJR Am J Roentgenol 149:105–107

    Article  CAS  PubMed  Google Scholar 

  17. Bureau NJ et al (2001) Lumbar facet joint synovial cyst: percutaneous treatment with steroid injections and distention. Radiology 221(1):179–185

    Article  CAS  PubMed  Google Scholar 

  18. Ghiselli G, Wang JC, Bhatia NN et al (2004) Adjacent segment degeneration in the lumbar spine. J Bone Joint Surg Am 86-A:1497–1503

    PubMed  Google Scholar 

  19. Trummer M, Flaschka G, Tillich M (2001) Diagnosis and surgical management of intraspinal synovial cysts report of 19 cases. J Neurol Neurosurg Psychiatr 70:74–77

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Hsu K, Zucherman J, Shea W, Jeffrey R (1995) Lumbar intraspinal synovial and ganglion cysts (facet cysts): ten-year experience in evaluation and treatment. Spine 20:80–89

    Article  CAS  PubMed  Google Scholar 

  21. Brown C, Stambough JL (2005) Epidural hematoma secondary to a rupture of a synovial cyst. Spine J 5:446–450

    Article  PubMed  Google Scholar 

  22. Bydon A, Xu R, Parker SL (2010) Recurrent back and leg pain and cyst reformation after surgical resection of spinal synovial cysts: systemic review of reported postoperative outcomes. Spine J 10:820–826

    Article  PubMed  Google Scholar 

  23. Liu XY, Zheng YP, Li JM, Gong LT (2009) Heminoplasty for the treatment of lumbar disc herniation. Int Orthop 33:1323–1327

    Article  Google Scholar 

  24. Howington J, Connolly E, Voorhies RM (1999) Intraspinal synovial cysts: ten-year experience at the Ochsner Clinic. J Neurosurg (Spine 2) 91:193–199

    Article  CAS  Google Scholar 

  25. Wybier M (2001) Imaging of lumbar degenerative changes involving structures other than disk space. Radiol Clin North Am 39:101–114

    Article  CAS  PubMed  Google Scholar 

  26. Finkelstein SD, Sayegh R, Watson P (1993) Juxta-facet cysts: report of two cases and review of clinicopathologic features. Spine 18:779–782

    Article  CAS  PubMed  Google Scholar 

  27. Wait SD, Jones FD, Lonser RR et al (2005) Symptomatic epidural hematoma caused by lumbar synovial cyst rupture: report of two cases and review of the literature. Neurosurgery 56(5):E1157 (discussion E)

    PubMed  Google Scholar 

  28. Wang Y, McKelvie P, Trost N (2004) Trauma as a precipitant of haemorrhage in synovial cysts. J Clinical Neuroscience 11(4):436–439

    Article  CAS  Google Scholar 

  29. Kaneko K, Inoue Y (2000) Haemorrhagic lumbar synovial cyst: a cause of acute radiculopathy. J Bone Joint Surg Br 82-B:583–584

    Article  Google Scholar 

  30. Nishida K, Iguchi T, Kurihara A (2003) Symptomatic hematoma of lumbar facet joint: joint apoplexy of the spine? Spine 28:E206–E208

    PubMed  Google Scholar 

  31. Eck Jason C, Triantafyllou Steven J (2005) Hemorrhagic lumbar synovial facet cyst secondary to anticoagulation therapy. Spine 5:451–453

    Article  Google Scholar 

  32. Vasani SS, Demetriades AK, Joshi SM (2007) Traumatic intraspinal extradural ganglion cyst in a teenager: case report and review of the literature. Clin Neurol Neurosurg 109:88–91

    Article  PubMed  Google Scholar 

  33. Cohen-Gadol AA, White JB, Lynch JJ (2004) Synovial cysts of the thoracic spine. J Neurosurg Spine 1:52–57

    Article  PubMed  Google Scholar 

  34. Yarde WL, Arnold PM, Kepes JJ (1995) Synovial cysts of the lumbar spine: diagnosis, surgical management, and pathogenesis. Report of eight cases. Surg Neurol 43:459–464

    Article  CAS  PubMed  Google Scholar 

  35. Sauvage P, Grimault L, Ben-Salem D, Roussin I, Huguenin M (2000) Kystes synoviaux lombaires: imagerie et traitement par infiltration, a propos de 13 observations. J Radiol 81(1):33–38

    CAS  PubMed  Google Scholar 

  36. Oertel MF, Ryang YM, Gilsbach JM (2006) Lumbar foraminal and far lateral juxtafacet cyst of intraspinal origin. Surg Neurol 66:197–199

    Article  PubMed  Google Scholar 

  37. Ramieri A, Domenicucci M, Seferi A (2006) Lumbar hemorrhagic synovial cysts: pathogenesis, and treatment. Report of three cases. Surg Neurol 65:385–390

    Article  PubMed  Google Scholar 

  38. Martha JF, Swaim B, Wand DA (2009) Outcome of percutaneous rupture of lumbar synovial cysts: a case series of 101 patients. Spine J 9:899–904

    Article  PubMed  Google Scholar 

  39. Daentzer D, Stüder D (2010) Thoracic juxtafacet cyst (JFC) as a rare cause of myelopathy-an additional reference to support the instability theory. Joint Bone Spine 77:178–180

    Article  PubMed  Google Scholar 

  40. Walcott BP, Coumans JV (2012) Postlaminectomy synovial cyst formation: a possible consequence of ligamentum flavum excision. J Clin Neurosci 19:252–254

    Article  PubMed  Google Scholar 

  41. Sabo RA, Tracy PT, Weinger JM (1996) A series of 60 juxtafacet cysts: clinical presentation, the role of spinal instability, and treatment. J Neurosurg 85:560–565

    Article  CAS  PubMed  Google Scholar 

  42. Khan AM, Synnot K, Cammisa FP (2005) Lumbar synovial cysts of the spine: an evaluation of surgical outcome. J Spinal Disord Tech 18:127–131

    Article  PubMed  Google Scholar 

  43. Teo, Lee KK (2004) The biomechanics of lumbar graded facetectomy under anterior-shear load. IEEE Biomedical Eng 51:443–449

    Article  CAS  Google Scholar 

  44. Natarajan RN, Andersson GBJ (1999) Study on effect of graded facetectomy on change in lumbar motion segment torsional flexibility using three-dimensional continuum contact representation for facet joints. J Biomech Eng 121:215–221

    Article  CAS  PubMed  Google Scholar 

  45. Rhee J, Anaizi AN, Sandhu FA (2012) Minimally invasive resection of lumbar synovial cysts from a contralateral approach. J Neurosurg Spine 17:453–458

    Article  PubMed  Google Scholar 

  46. Wiedemayer H, Sandalcioglu IE, Aalders M (2004) Reconstruction of the laminar roof with miniplates for a posterior approach in intraspinal surgery: technical considerations and critical evaluation of follow-up results. Spine 29:E333–E342

    Article  PubMed  Google Scholar 

  47. Yücesoy K, Ozer E (2002) Inverse laminoplasty for the treatment of lumbar spinal stenosis. Spine 27:E316–E320

    Article  PubMed  Google Scholar 

  48. Adachi K, Futami T, Ebihara A (2003) Spinal canal enlargement procedure by restorative laminoplasty for the treatment of lumbar canal stenosis. Spine 3(6):471–478

    Article  Google Scholar 

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The authors declare that they have no conflict of interest.

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Correspondence to Li Ming.

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Zhenbo, Z., Huanting, L., Jin, W. et al. Hemilaminoplasty for the treatment of lumbar intraspinal synovial cysts (LISCs) and literature review. Eur Spine J 25, 3393–3402 (2016). https://doi.org/10.1007/s00586-014-3570-x

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  • DOI: https://doi.org/10.1007/s00586-014-3570-x

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