{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T22:40:32Z","timestamp":1787611232040,"version":"build-2736575974"},"reference-count":11,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Overly extensive removal of the facet joint during lumbar facet synovial cyst (SC) excision may lead to iatrogenic instability. The objective of this study was to evaluate whether intraoperative navigation could better guide decisions regarding the need for simultaneous fusion.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>This prospective, single-surgeon study included eight patients with magnetic resonance imaging-confirmed lumbar SCs refractory to \u22656 weeks of conservative management. All underwent navigation-assisted unilateral biportal endoscopic decompression. Patients with preoperative dynamic X-ray evidence of instability were excluded. Intraoperative navigation quantified facet joint resection; those with \u226450% resection (Group A, <jats:italic>n<\/jats:italic> = 2) underwent decompression alone, while those with &gt;50% resection (Group B, <jats:italic>n<\/jats:italic> = 6) underwent unilateral instrumentation with interbody fusion. Outcomes at 12 months included Visual Analog Scale (VAS) (back and leg pain), Oswestry Disability Index (ODI), and radiographic evaluation for fusion or instability on plain and dynamic radiographs.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>The mean age was 48.6 years, and most procedures were performed at L4\u2013L5. Postoperative VAS and ODI scores documented improvement in all cases at 12 months. In Group B, 100% achieved radiographic fusion, while none of the Group A patients developed postoperative instability.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Intraoperative navigation allowed objective quantification of facet resection, guiding the selective use of fusion. Patients with &gt;50% resection achieved solid fusion, while those with \u226450% remained stable without fusion. This navigation-guided, data-driven strategy personalizes surgical management, reduces overtreatment, and enhances biomechanical safety.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_848_2025","type":"journal-article","created":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T08:39:00Z","timestamp":1760690340000},"page":"435","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Intraoperative navigation-based lumbar facet assessment for considering fusion in unilateral biportal endoscopic cyst excision"],"prefix":"10.25259","volume":"16","author":[{"given":"Shailesh","family":"Hadgaonkar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameer","family":"Nagpal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pramod Dashrath","family":"Bhilare","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parag","family":"Sancheti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2025,10,17]]},"reference":[{"key":"10.25259\/SNI_848_2025\/ref-1","doi-asserted-by":"crossref","first-page":"105011","DOI":"10.1016\/j.clinbiomech.2020.105011","article-title":"Lumbar stability following graded unilateral and bilateral facetectomy: A finite element model Present study (2025) Nav-based facet assessment\u00b1fusion 3D Nav Nav-UBE; decompr\u00b1fusion (>50% facet) Facet resection %, VAS (B\/L), ODI, OR, BL, instab study","volume":"75","author":"Ahuja","year":"2020","journal-title":"Clin Biomech (Bristol)"},{"key":"10.25259\/SNI_848_2025\/ref-2","doi-asserted-by":"crossref","first-page":"1410","DOI":"10.1097\/00007632-199506020-00014","article-title":"Anterior fresh frozen structural allografts in the thoracic and lumbar spine. Do they work if combined with posterior fusion and instrumentation in adult patients with kyphosis or anterior column defects?","volume":"20","author":"Bridwell","year":"1995","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.25259\/SNI_848_2025\/ref-3","doi-asserted-by":"crossref","first-page":"256","DOI":"10.3171\/2016.12.SPINE16756","article-title":"Synovial cysts of the spine: Long-term follow-up after surgical treatment of 141 cases in a single-center series and comprehensive literature review of 2900 degenerative spinal cysts","volume":"27","author":"Bruder","year":"2017","journal-title":"J Neurosurg Spine"},{"key":"10.25259\/SNI_848_2025\/ref-4","doi-asserted-by":"crossref","first-page":"78","DOI":"10.4103\/1793-5482.92162","article-title":"Surgical excision of a Juxtafacet cyst in the lumbar spine: A report of thirteen cases with long-term follow up","volume":"6","author":"El Shazly","year":"2011","journal-title":"Asian J Neurosurg"},{"key":"10.25259\/SNI_848_2025\/ref-5","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1097\/00007632-200405010-00018","article-title":"Lumbar laminectomy for the resection of synovial cysts and coexisting lumbar spinal stenosis or degenerative spondylolisthesis: An outcome study","volume":"29","author":"Epstein","year":"2004","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.25259\/SNI_848_2025\/ref-6","doi-asserted-by":"crossref","first-page":"690","DOI":"10.14444\/8293","article-title":"Patient outcomes after minimally invasive excision of lumbar synovial cysts, with and without a spondylolisthesis, in an ambulatory care center setting","volume":"16","author":"Francavilla","year":"2022","journal-title":"Int J Spine Surg"},{"key":"10.25259\/SNI_848_2025\/ref-7","doi-asserted-by":"crossref","first-page":"95","DOI":"10.2176\/nmc.53.95","article-title":"Synovial cysts of the lumbar spine--pathological considerations and surgical strategy","volume":"53","author":"Ganau","year":"2013","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"10.25259\/SNI_848_2025\/ref-8","doi-asserted-by":"crossref","first-page":"106667","DOI":"10.1016\/j.clineuro.2021.106667","article-title":"Outcomes and complications following minimally invasive excision of synovial cysts of the lumbar spine: A systematic review and meta-analysis","volume":"206","author":"Garg","year":"2021","journal-title":"Clin Neurol Neurosurg"},{"key":"10.25259\/SNI_848_2025\/ref-9","first-page":"e1318","article-title":"Targeted radiofrequency ablation as an adjunct in treatment of lumbar facet cysts","volume":"9","author":"Hatgis","year":"2017","journal-title":"Cureus"},{"key":"10.25259\/SNI_848_2025\/ref-10","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/j.mehy.2012.08.034","article-title":"Pathophysiology of regression of synovial cysts of the lumbar spine: The \u2018anti-inflammatory hypothesis","volume":"79","author":"Mattei","year":"2012","journal-title":"\u2019 Med Hypotheses"},{"key":"10.25259\/SNI_848_2025\/ref-11","doi-asserted-by":"crossref","first-page":"260","DOI":"10.3928\/0147-7447-20000301-21","article-title":"Indications for instrumentation in degenerative lumbar spinal disorders","volume":"23","author":"Vaccaro","year":"2000","journal-title":"Orthopedics"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/intraoperative-navigation-based-lumbar-facet-assessment-for-considering-fusion-in-unilateral-biportal-endoscopic-cyst-excision\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/intraoperative-navigation-based-lumbar-facet-assessment-for-considering-fusion-in-unilateral-biportal-endoscopic-cyst-excision\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T08:39:02Z","timestamp":1760690342000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/intraoperative-navigation-based-lumbar-facet-assessment-for-considering-fusion-in-unilateral-biportal-endoscopic-cyst-excision\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,17]]},"references-count":11,"alternative-id":["10.25259\/SNI_848_2025"],"URL":"https:\/\/doi.org\/10.25259\/sni_848_2025","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10,17]]},"article-number":"435"}}