Abstract
Objective: Our focus is on pathology and anatomy of the juxtaarticular intraspinal cysts, stability of the involved spinal segment and long-term outcome data in a group of surgically treated patients. Material and methods: Data from 49 patients treated surgically at the Department of Neurosurgery of the Charles University Teaching Hospital in Plzen, Czech Republic, from 2003 until 2010 were evaluated.
We assessed the degree of degenerative changes of the facet joint and intervertebral discs and morphology of juxtaarticular cysts. Stability of the spinal segment was evaluated using the X-rays.
We assessed changes in the Oswestry Score Index (ODI) and a visual analog scale (VAS) in 18 prospectively followed patients. Results: Intraspinal juxtaarticular cysts were mostly spherical (41%) with a thin wall.
Histological findings were uncertain in 47% of patients. Degenerative changes of the disc were of a lower degree than degeneration of the facet joint in 63% of patients.
Microsurgical resection of the cyst was the surgical procedure used. Lumbar spine instability was found in 16% of cases.
Improvement in VAS and ODI was statistically highly significant with lower back VAS p = 0.0205, lower extremity VAS p = 0.0001 and ODI with p = 0.0009. Conclusion: A unilateral intraspinal juxtaarticular cyst of the lumbar spine is not necessarily a sign of instability.
Histological findings do not determine treatment modality. Surgical resection of the cyst is a good treatment option with very good clinical results.
Because of unclear terminology, we suggest to use the term “intraspinal juxtaarticular cyst”.