European radiology · 2012
Symptomatic lumbar facet joint cysts treated by CT-guided intracystic and intra-articular steroid injections.
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Amoretti Nicolas, Huwart Laurent, Foti Pauline, Boileau Pascal, Amoretti Marie-Eve, Pellegrin Amelie, Marcy Pierre-Yves, Hauger Olivier
Аннотация
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.
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.
Предметные рубрики MeSH
AgedAged, 80 and overAnalysis of VarianceAnti-Inflammatory AgentsContrast MediaFemaleHumansInjections, Intra-ArticularInjections, IntralesionalLow Back PainLumbar VertebraeMaleMiddle AgedPain MeasurementPregnatrienesProspective StudiesRadiography, InterventionalSteroidsSynovial CystTomography, X-Ray ComputedTreatment OutcomeTriiodobenzoic AcidsZygapophyseal Joint