Procedure-based nonsurgical management of lumbar zygapophyseal joint cyst-induced radicular pain.
OBJECTIVE
To evaluate the success of fluoroscopically guided, contrast-enhanced lumbar zygapophyseal joint (Z-joint) aspiration and steroid injection combined with transforaminal epidural steroid injections (TFESIs) for the treatment of lumbar Z-joint cyst-induced radicular pain.


METHODS
Retrospective case series with independent follow-up.


METHODS
Institutional, referral center.


METHODS
Twenty-three patients referred to a single provider for procedure-based management of radicular pain believed secondary to lumbar Z-joint cyst. Inclusion criteria consisted of lumbar radicular pain that was consistent with the level and side of the Z-joint cyst as a causative lesion.


METHODS
Eighteen patients were treated with a fluoroscopically guided, contrast-enhanced Z-joint aspiration and steroid injection at the level of the causative cyst coupled with a fluoroscopically guided, contrast-enhanced TFESI over the level of the presumably irritated spinal nerve.


METHODS
Patient satisfaction, and whether or not surgery was performed.


RESULTS
Fifty percent of patients treated with the procedure had significant long-term benefit and avoided surgical intervention at an average follow-up of 9.9 months.


CONCLUSIONS
Fluoroscopically guided, contrast-enhanced spinal procedures as part of an aggressive nonsurgical treatment program are a safe and effective alternative to surgical intervention for lumbar Z-joint cyst-induced radicular pain.
Sabers
Steven R
SR
Department of Physical Medicine and Rehabilitation, Mayo Medical School, Rochester, MN 55905, USA.
Ross
Scott R
SR
Grogg
Brian E
BE
Lauder
Tamara D
TD
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007268:Injections, Epidural; D017116:Low Back Pain / Q000209:etiology / Q000628:therapy*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011379:Prognosis; D011843:Radiculopathy / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D016059:Range of Motion, Articular / Q000502:physiology; D012189:Retrospective Studies; D018570:Risk Assessment; D013256:Steroids / Q000008:administration & dosage*; D013581:Synovial Cyst / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000503:physiopathology*
D013256:Steroids