Radiologic Features and Surgical Outcome of Juxtafacet Cyst Associated with Degenerative Lumbar Disease / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to evaluate the radiologic features of juxtafacet cyst and determine the correlation between these features and clinical outcome. MATERIALS AND METHODS: We analyzed a total of 23 patients. The degree of facet joint degeneration was classified using the Fujiwara method. The facet joint angles were measured with an magnetic resonance imaging to determine whether there was a difference between the cystic lesion that was occupied and the cystic lesion that was not occupied. Disc degeneration was measured by the Pfirrmann classification method. The clinical result was evaluated using the Oswestry disability index score and visual analogue scale. RESULTS: The L4–5 level of juxtafacet cyst was mostly affected, as found in previous studies. Facet joint arthritis was more severe within the side with the cystic lesion. Significant correlation was found between disc degeneration and juxtafacet joint cyst. All patients underwent wide decompression and fusion. Clinical result was excellent. No patients had signs of recurrence during the follow-up periods. CONCLUSION: Juxtafacet cyst has a significant correlation with facet joint degeneration. Therefore, aggressive surgical treatment—not just simple cyst excision—should be considered as the treatment option for juxtafacet cyst associated with degenerative lumbar disease.

A Case of Juxtafacet Cyst of the Lumbar Spine Accompanied by Spinal Instability

A 37-year old man presented with radiating pain and hypesthesia of the right leg for one year, without a history of trauma. Clinical and radiological evaluation showed that he had bilateral L5 spondylolysis, spondylolisthesis L5 on S1, and a 1cm sized round epidural mass compressing the right L5 nerve root ventral to the right L5-S1 facet joint. After L5 total laminectomy and facetectomy, followed by excision of the juxtafacet cyst, L5-S1 pedicle screw fixation and L5-S1 intertransverse bone graft fusion were successfully performed. Rare reports of juxtafacet cysts have stated that they were often accompanied by spondylolisthesis and degenerative spinal changes, and associated with trauma and spinal instability. The authors believe that since spinal instability may be one of the causes of juxtafacet cysts, the removal of these may lead to spinal fusion.