Symptomatic lumbar facet joint cysts treated by CT-guided intracystic and intra-articular steroid injections

Eur Radiol. 2012 Dec;22(12):2836-40. doi: 10.1007/s00330-012-2533-z. Epub 2012 Jun 12.

Abstract

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.

Key points: 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.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Anti-Inflammatory Agents / administration & dosage*
  • Contrast Media
  • Female
  • Humans
  • Injections, Intra-Articular
  • Injections, Intralesional
  • Low Back Pain / diagnostic imaging
  • Low Back Pain / drug therapy*
  • Lumbar Vertebrae*
  • Male
  • Middle Aged
  • Pain Measurement
  • Pregnatrienes / administration & dosage*
  • Prospective Studies
  • Radiography, Interventional*
  • Steroids / administration & dosage*
  • Synovial Cyst / diagnostic imaging
  • Synovial Cyst / drug therapy*
  • Tomography, X-Ray Computed*
  • Treatment Outcome
  • Triiodobenzoic Acids
  • Zygapophyseal Joint*

Substances

  • Anti-Inflammatory Agents
  • Contrast Media
  • Pregnatrienes
  • Steroids
  • Triiodobenzoic Acids
  • iodixanol
  • cortivazol