An unusual cause for lumbar radiculopathy: a synovial facet joint cyst of the right L5 joint.

OBJECTIVE

To report a rare cause of lumbar radiculopathy. CLINICAL FEATURES: A 72-yr-old man suffered from pain that radiated down the posterior thigh and calf for 3 wk. The right foot and first toe extensors were weak and sensation was decreased over the dorsum of the foot. Straight leg raising was positive at 50 degrees on the right. Computed tomography with contrast revealed a large cyst with focal vacuum change with displacement of the dural sac at the L4-5 level. INTERVENTION AND OUTCOME: An L4-5 laminectomy and facetectomy was performed with relief of the patient's complaint. The patient resumed full activity at 3 months.

CONCLUSION

An unusual cause of an L5 radiculopathy is discussed. Of the reported cases, surgical intervention has been the treatment of choice. Conservative treatment, including injections with corticosteroids and chiropractic management, have been reported to be successful. Further investigations using controls are needed to determine if conservative care is more cost-effective than surgical intervention.