title: Percutaneous Translaminar Facet Cyst Rupture and Epidural Access-Description of a Novel Technique.
abstract: Synovial cysts of the lumbar zygapophysial joints can be treated by percutaneous injection of corticosteroids, with distension and rupture of the cyst. Some cysts can be difficult to access, particularly when they lie deep in relation to the lamina. This technical report describes a fluoroscopy-guided technique for accessing sublaminar pathology. Crucial to the safety of the technique is visualization of the ventral margin of the lamina using a contralateral oblique view, and controlling and limiting the insertion of the needle such that only its tip passes the lamina.
authors.affiliation: Department of Rehabilitation Medicine, Mount Sinai Hospital, New York, NY, USA.
authors.forename: David
authors.initials: D
authors.lastname: Spinner
authors.affiliation: Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Moris
authors.initials: M
authors.lastname: Aner
authors.affiliation: Department of Rehabilitation Medicine, Mount Sinai Hospital, New York, NY, USA.
authors.forename: Geet
authors.initials: G
authors.lastname: Paul
authors.affiliation: Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Simopoulos
authors.affiliation: Department of Anesthesiology, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Jatinder
authors.initials: J
authors.lastname: Gill
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D019635:Neurosurgical Procedures / Q000295:instrumentation / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013581:Synovial Cyst / Q000601:surgery*; D021801:Zygapophyseal Joint / Q000601:surgery*
chemical_list: D000305:Adrenal Cortex Hormones
keywords: Facet Joint; Fluoroscopy; Synovial Cyst; Zygoapophyseal Joint