Lumbar Facet Joint Cysts: Evaluating Clinical Trends and Treatment Outcomes in a Single-Centre Retrospective Case Series

Ramy Sherif*, Jorge Carter and MJH McCarthy

Introduction: Lumbar facet joint cysts are a rare but significant cause of back and radicular pain. Their infrequency leaves literature sparse and optimal management debated. This study analyzed the characteristics and treatment outcomes of facet joint cysts in patients within our Health Board, evaluating adherence to current management guidelines and treatment efficacy.

Materials and methods: A retrospective review included 87 patients diagnosed with lumbar facet joint cysts via MRI over 5 years. MRI findings were analyzed for cyst characteristics and associated spinal pathologies, while clinical records were reviewed for symptomatology and treatments received.

Results: Lumbar facet joint cysts were identified in 0.39% (87/22,292) of lumbar spine MRIs. Patients had a mean age of 61.2 years and a male-to-female ratio of 35:52. Cysts most commonly occurred at L4-L5 (50%) and L3-L4 (26.2%), with 62.8% causing neural compromise, predominantly affecting the left L5 nerve root. Symptoms were present in 70.1% of patients, with 43.7% undergoing interventions. Among treated patients, 89.5% received facet joint injections, but only 45.2% experienced short-term relief. Surgical outcomes were universally positive at 6 weeks, although 21.4% required further interventions.

Conclusion: While injections offer limited short-term relief, surgical treatment consistently provides superior outcomes. However, considering the risks of surgery, facet joint injections should remain the first-line approach, reserving surgery for refractory cases. This pragmatic strategy balances symptom control with patient safety, optimizing outcomes for this challenging condition.

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Published on: Dec 3, 2024 Pages: 1-7

Full Text PDF Full Text HTML DOI: 10.17352/ijsr.000025
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