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Lumbar Facet Joint Synovial Cyst: Percutaneous Treatment with Steroid Injections and Distention—Clinical and Imaging Follow-up in 12 Patients¹

¹ From the Department of Radiology, Centre Hospitalier de l’Université de Montréal, Hôpital Saint-Luc, 1058 Saint-Denis St, Montreal, Quebec, Canada H2X 3J4 (N.J.B.); and the Department of Bone and Joint Radiology, Massachusetts General Hospital, Boston (P.A.K., R.G.D). From the 2000 RSNA scientific assembly. Received December 27, revision requested February 8, 2001; revision received March 26; accepted April 10. Address correspondence to N.J.B. (e-mail: nathalie.bureau@umontreal.ca).

PURPOSE: To determine the imaging characteristics of lumbar facet joint synovial cysts after percutaneous treatment with steroid injections and distention of the cyst and to correlate these findings with the clinical outcome.

MATERIALS AND METHODS: Clinical outcome and imaging findings were retrospectively studied in 12 patients (four men, eight women) aged 45–79 years (mean, 60 years) with a symptomatic lumbar facet joint synovial cyst treated with percutaneous steroid injections. At varying times after the procedure, patients were contacted for clinical follow-up, and repeat imaging was performed to verify the status of the cyst.

RESULTS: Excellent pain relief was achieved in nine (75%) of 12 patients. At follow-up imaging, the cyst completely regressed in six (67%) of these nine patients, partially regressed in two (22%) patients, and was unchanged in one (11%) patient. One (8%) of the 12 patients had transient pain relief, with recurrence of symptoms at short intervals after each of three injections. No pain relief was achieved in two (17%) of 12 patients.

CONCLUSION: Image-guided percutaneous steroid injections are often effective in the treatment of lumbar facet joint synovial cysts and may result in complete regression of the cyst.

Index terms: Computed tomography (CT), guidance, 33.12112 • Spine, cysts, 33.779 • Spine, facet joints, 33.334 • Spine, interventional procedure, 33.1269 • Steroids

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