2023 American Academy of Neurology Abstract Website

Objective:

Is CT IR synovial cyst lumbar rupture effective in symptomatic lumbar synovial cyst to avoid surgical intervention in 1 year?

Background:

Synovial cysts are associated with facet joint degeneration and can cause of radiculopathy, back pain, and neurogenic claudication. Although definitive surgical removal of the cyst has been the preferred treatment in surgical literature, percutaneous facet synovial cyst rupture under fluoroscopy has been offered to symptomatic patients, with varying degree of effectiveness. CT guided rupture has been sparsely studied.

Design/Methods:

Method of Data Collection: Electronic chart review, use of SlicerDicer EPIC application with data analysis, review of imaging modalities including MRI and CT

Study Population: Adult patients (18 years old and greater) with lumbar synovial cysts resulting in radicular pain and have undergone cyst rupture via CT guidance for 1 year between 6/2015- 6/2022

Characteristics reported include patient demographics, Clinical/neurological examination before and after procedure, Pain, MRI characteristics of cyst, other pain medication used, Patient past medical history, how many IR procedures done in 1 year, complications from procedure

Results:

Obtained 6 suitable patients for the study and 1 out of 6 patients had undergone surgical intervention.

Conclusions:

CT IR guided lumbar cyst rupture resulted in short term, mild to moderate improvement of radicular symptoms with 5 patients receiving multiple treatments with 1 patient undergoing surgery in less than 1 year.

Characteristics of patients showed cysts were in L4-5 to L5-S1 location, pain as per visual analog scale score 8-10/10, in which afterward cyst rupture improved to >4. Neurological examinations prior and post rupture were overall benign with no adverse events, except one undergoing surgery within 1 year. This patient showed foot adductor weakness prior to procedure, radicular sensory symptoms post laminectomy.

This analysis may indicate that there is efficacy in undergoing lumbar cyst rupture to alleviate radicular symptoms for 1 year.