Percutaneous CT-guided facet joint synovial cyst rupture: Success with refractory cases and technical considerations


      • Lumbar facet synovial cysts can be successfully treated via a minimally invasive percutaneous approach with CT-guidance.
      • CT-guidance may offer improved rates of cyst rupture and clinical improvement when compared to fluoroscopic guidance.
      • Percutaneous cyst rupture can improve patient outcomes at >12-months follow-up and avoid open surgery.


      Percutaneous image-guided rupture of lumbar facet synovial cysts can improve clinical outcomes and obviate the need for open surgery. This series describes eleven patients who had successful CT-guided lumbar facet synovial cyst ruptures, 82% of which experienced excellent pain relief at a minimum of one-year follow-up. Of the five patients who failed prior fluoroscopic-guided synovial cyst rupture, 80% had a successful CT-guided rupture and one-year sustained pain relief. These findings reinforce minimally invasive CT-guided treatment as an excellent option to improve patient symptoms and potentially avoid open surgery.


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