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Kulkarni AG, Dutta S, Dhruv A, et al. Should We Label All Synovial Cysts as Unstable?. Global Spine J. 2017;7(7):629-635doi: 10.1177/2192568217700103.
Kulkarni, A. G., Dutta, S., Dhruv, A., & Bassi, A. (2017). Should We Label All Synovial Cysts as Unstable?. Global spine journal, 7(7), 629-635. https://doi.org/10.1177/2192568217700103
Kulkarni, Arvind G, et al. "Should We Label All Synovial Cysts as Unstable?." Global spine journal vol. 7,7 (2017): 629-635. doi: https://doi.org/10.1177/2192568217700103
Kulkarni AG, Dutta S, Dhruv A, Bassi A. Should We Label All Synovial Cysts as Unstable?. Global Spine J. 2017 Oct;7(7):629-635. doi: 10.1177/2192568217700103. Epub 2017 May 31. PMID: 28989841; PMCID: PMC5624374.
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Global Spine J. 2017 Oct;7(7):629-635. doi: 10.1177/2192568217700103. Epub 2017 May 31.

Should We Label All Synovial Cysts as Unstable?.

Global spine journal

Arvind G Kulkarni, Shumayou Dutta, Abhilash Dhruv, Anupreet Bassi

Affiliations

  1. Bombay Hospital & Medical Research Centre, Mumbai, India.

PMID: 28989841 PMCID: PMC5624374 DOI: 10.1177/2192568217700103

Abstract

STUDY DESIGN: Retrospective study.

OBJECTIVE: To analyze the various anatomical parameters that influence segmental stability in patients suffering from lumbar intra spinal cysts (LISCs) and to determine the outcome of microscopic unilateral laminotomy and cystectomy.

METHODS: All patients that were surgically managed for a LISC between 2007 and 2013 with more than 3 years of follow-up were reviewed. Those without associated instability were evaluated for segmental mobility, segmental angulation, facet inclination, stage of disc degeneration, and level of involvement on MRI and dynamic radiographs. Outcomes of unilateral laminotomy and cystectomy were evaluated using VAS (Visual Analogue Score), ODI (Oswestry Disability Index), and Macnabs criteria. Dynamic radiographs were performed in all cases pre- and postoperatively and at the last follow-up.

RESULTS: Thirty patients were operated for a LISC between 2007 and 2013. The levels involved were L4-5(23), L3-4(4) and L5-S1(3). The mean facet angle was 42.6 (± 6.1) degrees. The stage of disc degeneration was scattered haphazardly across all the cases (Gr 2[17]; Gr 3[1]; Gr 4[8]; Gr 5[4]). VAS and ODI scores improved significantly in all patients. Mean follow-up was 46.5 months (36-96 months). No patient developed postoperative instability at the last follow-up.

CONCLUSIONS: The coronal inclination of the facet joints, absence of radiological instability, and poor co-relation with stages of disc degeneration suggests the presence of adequate residual stability. In this study, stand-alone decompression for LISCs without instability had well sustained good/excellent outcomes. Fusion is recommended for LISCs with associated instability.

Keywords: degenerative spondylolisthesis; facet cyst; spinal fusion; spinal instability; spine surgery

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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