Symptomatic lumbar facet joint cysts treated by CT-guided intracystic and intra-articular steroid injections.
OBJECTIVE
To evaluate percutaneous computed tomography (CT)-guided intracystic and intra-articular steroid injections for the treatment of lumbar facet joint cyst causing radicular pain.


METHODS
A single-centre prospective study involving 120 consecutive patients with symptomatic lumbar facet joint cyst-induced radicular pain was done (72 women, 48 men). The average age was 68.2 years (52-84). Patients were treated by percutaneous CT-guided intracystic and intra-articular steroid injections. The clinical course of nerve root pain was evaluated after 1 day, and 1, 3 and 6 months, with long-term follow-up after 12 months.


RESULTS
Patient follow-ups in our series show supportive results: within 120 patients, 54% of patients were satisfied with a long-lasting result from the first intra-cystic and intra-articular steroid injections (n = 65), while 20.8% were satisfied with a long-lasting result from a second intervention. Combining these two results shows that 75% of patients were satisfied with a long-lasting result.


CONCLUSIONS
Our results showed that percutaneous treatment of vertebral lumbar facet joint cysts by double injections is an effective and economic therapeutic technical management among 75% of our patients. Thus we recommend that it should be considered as a first choice of treatment.


CONCLUSIONS
Lumbar facet joint cysts are a common feature of back and radicular pain. They may be treated effectively by interventional radiologists using CT guidance. Percutaneous treatment using double injections can save surgery in 75% of patients.
Department of Radiology, Centre Hospital-Universitaire de Nice, Hôpital Archet 2, 151, Route de Saint Antoine de Ginestière, 06200, Nice, France. Amorettinicolas@yahoo.fr
Nicolas
N
Amoretti
Laurent
L
Huwart
Pauline
P
Foti
Pascal
P
Boileau
Marie-Eve
ME
Amoretti
Amelie
A
Pellegrin
Pierre-Yves
PY
Marcy
Olivier
O
Hauger
D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003287:Contrast Media; D005260:Female; D006801:Humans; D007270:Injections, Intra-Articular; D015552:Injections, Intralesional; D017116:Low Back Pain / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008159:Lumbar Vertebrae; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011281:Pregnatrienes / Q000008:administration & dosage*; D011446:Prospective Studies; D015641:Radiography, Interventional; D013256:Steroids / Q000008:administration & dosage*; D013581:Synovial Cyst / Q000000981:diagnostic imaging / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014283:Triiodobenzoic Acids; D021801:Zygapophyseal Joint
D000893:Anti-Inflammatory Agents; D003287:Contrast Media; D011281:Pregnatrienes; D013256:Steroids; D014283:Triiodobenzoic Acids; C044834:iodixanol; C005924:cortivazol