RT Journal Article
SR Electronic
T1 Long-term pain relief following percutaneous steroid treatment of spinal synovial cysts: a population-based cohort study
JF Journal of NeuroInterventional Surgery
JO J NeuroIntervent Surg
FD BMJ Publishing Group Ltd.
SP 874
OP 878
DO 10.1136/neurintsurg-2020-015890
VO 12
IS 9
A1 Alexander Fletcher-Sandersjöö
A1 Erik Edström
A1 Åsa Kuntze Söderqvist
A1 Per Grane
A1 Adrian Elmi-Terander
YR 2020
UL http://jnis.bmj.com/content/12/9/874.abstract
AB Background Spinal synovial cysts are fluid-filled sacs that develop after facet joint degeneration and can give rise to radicular pain. If resistant to conservative management, surgical decompression or percutaneous steroid treatment is usually recommended. Percutaneous treatment minimizes the risk of spinal instability, but it has been uncertain whether it provides any long-term symptom relief. Moreover, it is unclear whether cyst rupture provides any added benefit.Objective To assess long-term pain relief in patients with spinal synovial cysts who were treated with percutaneous intra-articular steroid treatment without cyst rupture.Methods A population-based cohort-study was conducted of all patients with symptomatic synovial cysts who were treated with percutaneous intra-articular steroid treatment without cyst rupture between 1995 and 2014.Results Thirty-eight patients were included. All patients had variations of lower back and radicular pain. Intra-articular access was achieved in 35 (92%) patients, and there were no treatment-related complications. At short-term assessment, 30 (79%) had pain relief. During the median follow-up of 11 years, 12 (32%) patients showed sustained pain relief without the need for decompressive surgery.Conclusions Percutaneous intra-articular steroid treatment without cyst rupture is a safe treatment for symptomatic spinal synovial cysts and eliminates the need for surgery in a substantial number of patients. It can be suggested as a first line of treatment.