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Symptomatic Lumbar Facet Joint Synovial Cysts: Clinical Assessment of Facet Joint Steroid Injection after 1 and 6 Months and Long-term Follow-up in 30 Patients

¹ Departments of Bone and Joint Radiology (C.P.C., M.W., J.D.L.)
² Orthopedic Surgery (R.N.), Hôpital Lariboisière, AP-HP, Assistance Publique des Hôpitaux de Paris, 2 rue Ambroise Paré, 75010 Paris, France
³ Department of Radiology, Hôpital la Timone, Marseille, France (P.C.)
⁴ Department of Radiology, Hôpital Saint-Antoine, Assistance Publique des Hôpitaux de Paris, France (P.L.H.).

PURPOSE: To study the results of facet joint intraarticular steroid injections in patients with symptomatic lumbar facet joint synovial cysts.

MATERIALS AND METHODS: Data from 30 patients (age range, 44–82 years; mean age, 67 years) with nerve root pain due to a lumbar facet joint synovial cyst and treated with facet joint steroid injection were retrospectively studied. On the basis of MacNab criteria, the clinical course of nerve root pain was evaluated after 1 (n = 30) and 6 (n = 28) months. Data from long-term follow-up (mean, 26 months) were also available in 14 nonsurgically treated patients.

RESULTS: After 1 month, the nerve root pain outcome was excellent or good in 20 patients (67%) and fair or poor in 10 (33%). After 6 months, 10 (50%) of these 20 patients still had excellent or good results, and 18 (60%) of the 30 patients had a fair or poor clinical status, 14 of whom underwent surgery; two patients (7%) were lost to follow-up. Excellent and good results were maintained at further follow-up (range, 9–50 months).

CONCLUSION: One-third of patients with symptomatic lumbar facet joint synovial cysts had long-lasting acceptable benefit from facet joint steroid injections in this study. Steroid injection should be indicated before surgery.

Index terms: Interventional procedures, 334.1269 • Spine, cysts, 334.3611 • Spine, facet joints, 334.3611 • Steroids, 334.1269

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