Facet joint cysts, also called synovial cysts, are benign, fluid-filled sacs that develop due to degeneration of the facet joints of the spine. These cysts normally occur in the lumbar spine (lower back) area and may not cause problems, but when large enough, they can cause spinal stenosis or narrowing of the spinal canal leading to compression of the spinal cord or spinal nerves.
Spinal stenosis caused by a facet joint cyst may be associated with:
Rarely, a facet joint cyst can lead to cauda equina syndrome, a serious condition which can lead to paralysis and loss of bladder and bowel function. This may be permanent if not treated emergently.
Surgical removal of the facet joint cyst is indicated when symptoms are severe and not relieved by conservative treatment such as pain medication, activity modification and joint injections.
Imaging studies of the spine are performed to plan the surgery. You may have to stop taking certain medications prior to the procedure. Smokers are advised to quit well before the procedure to avoid problems such as delayed healing and infection.
To remove the cyst and relieve pressure on the spinal cord or spinal nerves your doctor will perform a procedure called microdecompression. This is often followed by fusion of the adjacent vertebrae to avoid recurrence of the cyst.
The procedure is performed under general anaesthesia and you will lie face down on the operating table.
If spinal fusion is indicated, bone graft is placed between the vertebrae being fused. Metal plates, screws or rods are used to hold the vertebrae while the bones fuse. Fusing the joint provides stability and prevents the cyst from regenerating.
As you recover from surgery, you may be instructed to:
As with any form of spine surgery, there are certain risks associated with removal of a facet joint cyst. These include but are not limited to:
Potential benefits of facet joint cyst removal include: