title: Lumbar facet cyst resolution following anterior interbody fusion.
abstract: Facet cysts are a relatively common source of neural compression in the lumbar spine. Open decompression and fusion are frequently used to treat the stenosis and instability associated with this pathology. Recently, anterior lumbar interbody fusion (ALIF) has increased in popularity for the treatment of lumbar degenerative conditions. ALIF may achieve indirect decompression of the neural elements with less surgical morbidity than conventional open approaches. To date, there are no published reports describing the use of indirect decompression or interbody fusion for the treatment of facet cysts. We report a patient who developed an L4-L5 facet cyst secondary to degenerative changes and spondylolisthesis. ALIF with posterior instrumentation was used to address his condition. Six months after surgery, the patient had complete resolution of his symptoms. MRI revealed complete resolution of the facet cyst. This patient provides previously unreported evidence that interbody fusion alone may result in facet cyst resolution. Clinical studies are needed to evaluate if interbody fusion can consistently relieve the symptoms associated with facet cysts without the use of direct decompression.
authors.affiliation: Department of Orthopaedic Surgery, Duke University Medical Center, Box 2807, 335 Baker House, 200 Trent Drive, Durham, NC, USA.
authors.forename: Gene M
authors.initials: GM
authors.lastname: Massey
authors.forename: Adam M
authors.initials: AM
authors.lastname: Caputo
authors.forename: Keith W
authors.initials: KW
authors.lastname: Michael
authors.forename: Robert E
authors.initials: RE
authors.lastname: Isaacs
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Brown
mesh_terms: D003560:Cysts / Q000473:pathology / Q000601:surgery*; D006801:Humans; D055959:Intervertebral Disc Degeneration / Q000473:pathology / Q000601:surgery; D017116:Low Back Pain / Q000473:pathology / Q000601:surgery; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013122:Spinal Diseases / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013168:Spondylolisthesis / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome; D021801:Zygapophyseal Joint / Q000473:pathology / Q000601:surgery*
keywords: Degenerative spondylolisthesis; Extreme lateral interbody fusion; Facet ablation; Zygapophysial cyst