Variety of Techniques Effective for Treating Spinal Synovial Cysts

Fusion surgery reduces risk of spinal synovial cyst recurrence, but may trigger complications

THURSDAY, Oct. 4 (HealthDay News) -- For patients with spinal synovial cysts, the majority who undergo surgery have excellent or good outcomes, according to a study published online Sept. 6 in the Journal of Spinal Disorders & Techniques.

Steven Knafo, M.D., of the Université of Paris-Descartes, and associates conducted a retrospective review of 23 patients with spinal synovial cysts who underwent surgery at a single institution between 2004 and 2010. Four categories of surgical procedures were examined: cystectomy via an inter-laminar approach (11 patients), via hemi-laminectomy (eight patients), via laminectomy (two patients), or associated with instrumented spinal fusion (two patients), and outcomes were compared between the groups.

The researchers found that 16 patients (69.6 percent) achieved excellent or good clinical outcomes on the Macnab modified scale. Two perioperative complications, two cyst recurrences, and one secondary fusion occurred. In a review of 519 patients reported in the literature, 83 percent had excellent or good clinical outcome. Unfavorable outcome was significantly more likely in patients treated with decompression alone (20.2 versus 8.1 percent; P = 0.003), as was cyst recurrence (P = 0.028). In the fusion versus the decompression alone group, the rate of perioperative complications was significantly higher (18.7 versus 2.8 percent; P < 0.0001).

"In the end, it will be a mixture of clinical judgment and evidence-based knowledge that will lead to the right decision for a given patient over which technique should be used and even whether the patient should be operated [on] in the first place," the authors write.

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