Endoscopic resection of intraspinal facet cysts

S. Hellinger

doi:10.3969/j.issn.2095-252X.2016.05.002

Abstract：Objective To investigate the clinical outcomes and surgical techniques of percutaneous endoscopic resection of intraspinal facet cysts.Methods Seven patients diagnosed with intraspinal facet cysts treated endoscopically were included in this prospective trial. All patients underwent a minimum of 6 weeks of nonoperative management prior to the endoscopic resection. Transforaminal endoscopic cyst resection or interlaminar approach cyst resection were performed depending on the morphology of the cysts. A retrospective analysis of hospital charts, MRI images was performed for each patient included in this study. The follow up was up to one year. In selected cases a comparison of imaging was performed after surgery.Results The patient’s postoperative outcomes were graded using visual analog scale ( VAS ) and Macnab criteria. Furthermore, the morphological comparison of the removed cysts was included following endoscopic resection of their facet cysts. The average duration of the surgery was 53 minutes. There was no signiifcant blood loss. Two patients achieved an excellent outcome; four reported a good result and one had a fair result. The patients with good and fair outcome noticed that their radicular pain and claudication were relieved after surgery very well, but in some cases low back pain was still bothersome.Conclusions Endoscopic surgery in the hand of skilled surgeons seemed to be a good option for the treatment of facet cysts. It helps to avoid collateral damage and an increased instability. The endoscopic visualization allows a proper preparation and resection of the pathological structures and a good decompression of the spinal channel. Before an open laminectomy with or without fusion the endoscopic technique should be considered.