Lumbar juxtafacet cyst resection: the facet sparing contralateral minimally invasive surgical approach.

Publication Type	Academic Article
Authors	James A, Laufer I, Parikh K, Nagineni V, Saleh T, Härtl R
Journal	J Spinal Disord Tech
Volume	25
Issue	2
Pagination	E13-7
Date Published	04/01/2012
ISSN	1539-2465
Keywords	Minimally Invasive Surgical Procedures, Orthopedic Procedures, Spine, Synovial Cyst, Zygapophyseal Joint
Abstract	STUDY DESIGN: A retrospective review. OBJECTIVE: To report our approach and results using a contralateral minimally invasive spinal surgical muscle splitting approach that allows visualization of the cyst without extensive removal of the adjacent facet joint. SUMMARY OF BACKGROUND DATA: The use of tubular retractors for spinal surgery can potentially minimize tissue injury. Contralateral approaches may be beneficial in visualizing pathology that is located adjacent or under the facet joint. This approach has not been reported previously. METHODS: Sixteen consecutive patients were treated using this approach using tubular retractors and the operating microscope. A retrospective chart and imaging review was conducted to determine operative and clinical measures. Subsequently, patients were contacted to obtain long-term clinical follow-up. RESULTS: Nine patients had an excellent and 5 had a good outcome, with median follow-up of 18 months, 2 patients were lost due to lack of follow-up. The mean operative time was 105 minutes and in all cases the blood loss was <40 mL. No postoperative instability was noted. CONCLUSIONS: A contralateral approach using a tubular retractor system provides excellent visualization of the facet cyst allowing safe cyst resection and nerve root decompression without compromising the facet joint. Larger case series with longer follow-up are needed to assess stability.
DOI	10.1097/BSD.0b013e31822ac4e5
PubMed ID	21909035