Lumbar laminectomy for the resection of synovial cysts and coexisting lumbar spinal stenosis or degenerative spondylolisthesis: an outcome study.
METHODS
Surgeon- and patient-based (SF-36) outcome measures were used to assess the results of decompressive laminectomies for the excision of synovial cysts with coexistent lumbar spinal stenosis (45 patients) or for synovial cysts with coexistent lumbar stenosis and degenerative spondylolisthesis (35 patients).


OBJECTIVE
To evaluate the results following laminectomy and the excision of synovial cysts/stenosis with or without olisthy.


BACKGROUND
SF-36 outcome studies evaluating these surgical results deserve further investigation.


METHODS
Before surgery, patients with synovial cysts/ stenosis (45 patients) or cysts/stenosis/degenerative spondylolisthesis (35 patients), respectively, exhibited low back pain (40 and 33 patients), radiculopathy (43 and 33 patients), and neurogenic claudication (41 and 26 patients). Surgery required average 3.8 and 3.5 level laminectomies, respectively, for patients with cysts/stenosis and cysts/stenosis and olisthy. Outcomes were assessed 2 years after surgery.


RESULTS
Five of 45 patients undergoing laminectomy alone for cysts/stenosis developed postoperative olisthy. Of 35 patients with cysts/stenosis and preoperative Grade 1 degenerative spondylolisthesis, olisthy increased after surgery to Grade 2 in 11 patients. Good/excellent results (58% and 63%) and SF-36 improvement on the Physical Function Scale (+44 and +38 points) were, respectively, documented for these two groups.


CONCLUSIONS
Using both surgeon and SF-36 outcome measures, 2 years following laminectomy for synovial cysts/lumbar stenosis with or without olisthy, patients exhibited a moderate degree of improvement. As synovial cysts reflect disruption of the facet joint and some degree of instability, primary fusion should be considered to improve operative results for patients in both categories.
Epstein
Nancy E
NE
Department of Neurological Surgery, Albert Einstein College of Medicine, Bronx, NY, USA. Nepstein@lineurosurg.com
D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007796:Laminectomy; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009518:New York; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D013130:Spinal Stenosis / Q000150:complications / Q000601:surgery*; D013168:Spondylolisthesis / Q000150:complications / Q000601:surgery*; D013581:Synovial Cyst / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D014057:Tomography, X-Ray Computed