Introduction: Lumbar synovial cysts are a relatively common clincial finding. Surgical treatment of symptomatic synovial cysts includes CT-guided aspiration, open resection and microendoscopic resection. We report our series of 40 microendoscopic tubular lumbar synoival cyst resections.
Methods: Following IRB approval, retrospective analysis of 40 cases of microendoscopic tubular retractor synovial cyst resections at a single instituion by a single surgeon (BDB) was conducted. Gross total resection was performed in all cases.
Results: Patient characteristics, surgical operating time, complications and outcomes were analyzed. There were 27 females and 13 males. The most common level was L4/L5 73% (29/40), L5/S1 20% (8/40) and L3/L4 7% (3/40). Lumbar radiculopathy was the presenting symptoms in all patients. Median age 64 years (range 45-82). Median duration of symptoms 6.5 months (range 1-25). Smoking history, body mass index and non-medical legal indicies were accounted. Median operating time was 58 minutes (range 25-110). Median blood loss was 20 ml (range 5-50). All patients were done as outpatients. Seven patients required overnight observation status. The remining 33 patients' median length of stay was 4 hours. There were two CSF leaks repaired directly without sequelae. Followup was a minimum of 8 months with median 80 months (range 8-250). Good or excellent outcomes in 38/40 patients and two were fair or poor. Two patients required fusion during follow-up period. These results compare favorably with open procedures as reported in the literature.
Conclusions: Microendoscopic tubular retractor resection of lumbar synovial cysts can be done safely and with comparable outcomes and complication rates as open procedures and potentially reduced operative time and length of stay. Patient selection for microendoscopic tubular synovial cyst resection is based in part on the anatomy of the synovial cyst and is critical when recommending endoscopic versus open resection to patients.
Patient Care: Microendoscopic tubular retractor resection of lumbar synovial cysts is an effective and low risk option for porperly selected patients.
Learning Objectives: Microendoscopic resection of lumbar synovial cysts can be done with low morbidity and good outcomes.
Microendoscopic resection of lumbar synovial cysts can be done with minimal blood loss
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