Treatment of Synovial Cyst Stenosis With Radiofrequency Lesioning of the Posterior Facet Capsule - A Case Report of Two Patients.

BACKGROUND

Zygapophyseal joint synovial cyst spinal stenosis can cause radicular pain issues that often require repetitive cystic rupture procedures or decompressive surgery for resolution.

CASE REPORT: We present 2 cases of lumbar spinal stenosis with radicular findings due to lumbar zygapophyseal synovial cyst impingement that were not improved with physical therapy, epidural steroid injections, synovial cyst injections, or transforaminal injections. Synovial cysts were 1 cm and 0.7 cm preprocedure, respectively, for these 2 patients. Both cases were treated with radiofrequency (RF) lesioning of the posterior facet capsule at 3 locations from medial to lateral along the facet joint line posteriorly at the affected spinal level with complete resolution of the radicular symptoms in both cases. Follow-up was 6 months and 10 years for the 2 patients.

CONCLUSIONS

RF lesioning of the synovial capsule may be an effective treatment for synovial cyst stenosis in lieu of conventional surgery or repetitive cyst rupture techniques.