{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T04:49:19Z","timestamp":1783140559932,"version":"3.54.6"},"reference-count":50,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:sec>\n<jats:title>OBJECT<\/jats:title>\n<jats:p>The authors sought to determine patient-related outcomes after minimally invasive surgical (MIS) lumbar intraspinal synovial cyst excision via a tubular working channel and a contralateral facet-sparing approach.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>All the patients with a symptomatic lumbar intraspinal synovial cyst who underwent surgery at the University of Iowa Hospitals and Clinics with an MIS excision via a contralateral approach were treated between July 2010 and August 2014. There was a total of 13 cases. Each patient was evaluated with preoperative neurological examinations, lumbar spine radiography, MRI, and visual analog scale (VAS) scores. The patients were evaluated postoperatively with neurological examinations and VAS and Macnab scores. The primary outcomes were improvement in VAS and Macnab scores. Secondary outcomes were average blood loss, hospital stay duration, and operative times.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>There were 5 males and 8 females. The mean age was 66 years, and the mean body mass index was 28.5 kg\/m<jats:sup>2<\/jats:sup>. Sixty-nine percent (9 of 13) of the cysts were at L4\u20135. Most patients had low-back pain and radicular pain, and one-third of them had Grade 1 spondylolisthesis. The mean (\u00b1 SD) follow-up duration was 20.8 \u00b1 16.9 months. The mean Macnab score was 3.4 \u00b1 1.0, and the VAS score decreased from 7.8 preoperatively to 2.9 postoperatively. The mean operative time was 123 \u00b1 30 minutes, with a mean estimated blood loss of 44 \u00b1 29 ml. Hospital stay averaged 1.5 \u00b1 0.7 days. There were no complications noted in this series.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>The MIS excision of lumbar intraspinal synovial cysts via a contralateral approach offers excellent exposure to the cyst and spares the facet joint at the involved level, thus minimizing risk of instability, blood loss, operative time, and hospital stay. Prospective randomized trials with longer follow-up times and larger cohorts are needed to conclusively determine the superiority of the contralateral MIS approach over others, including open or ipsilateral minimally invasive surgery.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.1.spine14996","type":"journal-article","created":{"date-parts":[[2015,6,26]],"date-time":"2015-06-26T14:06:06Z","timestamp":1435327566000},"page":"444-450","source":"Crossref","is-referenced-by-count":25,"title":["Minimally invasive resection of lumbar intraspinal synovial cysts via a contralateral approach: review of 13 cases"],"prefix":"10.3171","volume":"23","author":[{"given":"Hamdi G.","family":"Sukkarieh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick W.","family":"Hitchon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olatilewa","family":"Awe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Noeller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-spine14996","series-title":"Eur Radiol","doi-asserted-by":"publisher","first-page":"2836","DOI":"10.1007\/s00330-012-2533-z","article-title":"Symptomatic lumbar facet joint cysts treated by CT-guided intracystic and intra-articular steroid injections","volume":"22","author":"Amoretti","year":"2012"},{"key":"b2-spine14996","series-title":"Eur Radiol","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1007\/s003300050973","article-title":"MR imaging of lumbar facet joint synovial cysts","volume":"10","author":"Apostolaki","year":"2000"},{"key":"b3-spine14996","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1007\/BF01844747","article-title":"Synovial cysts: clinical and neuroradiological aspects","volume":"139","author":"Artico","year":"1997"},{"key":"b4-spine14996","series-title":"J Am Acad Orthop Surg","doi-asserted-by":"publisher","first-page":"160","DOI":"10.5435\/JAAOS-20-03-160","article-title":"The impact of the Spine Patient Outcomes Research Trial (SPORT) results on orthopaedic practice","volume":"20","author":"Asghar","year":"2012"},{"key":"b5-spine14996","series-title":"Contemporary Neurosurgery","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/01.CNE.0000437421.05494.bd","article-title":"Minimally invasive surgery for lumbar synovial cysts","volume":"35","author":"Awe","year":"2013"},{"key":"b6-spine14996","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1097\/00007632-200104150-00024","article-title":"Patient outcome after resection of lumbar juxtafacet cysts","volume":"26","author":"Banning","year":"2001"},{"key":"b7-spine14996","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1007\/s00586-007-0563-z","article-title":"Spinal synovial cysts: pathogenesis, diagnosis and surgical treatment in a series of seven cases and literature review","volume":"17","author":"Boviatsis","year":"2008"},{"key":"b8-spine14996","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"179","DOI":"10.1148\/radiol.2211010213","article-title":"Lumbar facet joint synovial cyst: percutaneous treatment with steroid injections and distention\u2014clinical and imaging follow-up in 12 patients","volume":"221","author":"Bureau","year":"2001"},{"key":"b9-spine14996","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1016\/j.spinee.2010.04.010","article-title":"Recurrent back and leg pain and cyst reformation after surgical resection of spinal synovial cysts: systematic review of reported postoperative outcomes","volume":"10","author":"Bydon","year":"2010"},{"issue":"5 Suppl 2","key":"b10-spine14996","series-title":"Neurosurgery","first-page":"356","article-title":"Primary dural repair during minimally invasive microdiscectomy using standard operating room instruments","volume":"64","author":"Chou","year":"2009"},{"key":"b11-spine14996","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"52","DOI":"10.3171\/spi.2004.1.1.0052","article-title":"Synovial cysts of the thoracic spine","volume":"1","author":"Cohen-Gadol","year":"2004"},{"key":"b12-spine14996","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1097\/01.bsd.0000188660.31212.83","article-title":"Microsurgical treatment of juxta facet cysts of the lumbar spine","volume":"19","author":"Deinsberger","year":"2006"},{"key":"b13-spine14996","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1097\/01.bsd.0000096267.75190.eb","article-title":"Lumbar synovial cysts: a review of diagnosis, surgical management, and outcome assessment","volume":"17","author":"Epstein","year":"2004"},{"key":"b14-spine14996","series-title":"Zentralbl Neurochir","doi-asserted-by":"publisher","first-page":"147","DOI":"10.1055\/s-2005-836475","article-title":"Resolution of a synovial cyst of the lumbar spine without surgical therapy \u2014 a case report","volume":"66","author":"Ewald","year":"2005"},{"key":"b15-spine14996","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"293","DOI":"10.3171\/jns.1987.66.2.0293","article-title":"A posttraumatic lumbar spinal synovial cyst. Case report","volume":"66","author":"Franck","year":"1987"},{"key":"b16-spine14996","series-title":"Neurosurgery","first-page":"989","article-title":"Experience with symptomatic spinal epidural cysts","volume":"34","author":"Freidberg","year":"1994"},{"key":"b17-spine14996","series-title":"Neurol Med Chir (Tokyo)","doi-asserted-by":"publisher","first-page":"95","DOI":"10.2176\/nmc.53.95","article-title":"Synovial cysts of the lumbar spine\u2014pathological considerations and surgical strategy","volume":"53","author":"Ganau","year":"2013"},{"issue":"2 Suppl","key":"b18-spine14996","series-title":"J Neurosurg","first-page":"193","article-title":"Intraspinal synovial cysts: 10-year experience at the Ochsner Clinic","volume":"91","author":"Howington","year":"1999"},{"key":"b19-spine14996","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"80","DOI":"10.1097\/00007632-199501000-00015","article-title":"Lumbar intraspinal synovial and ganglion cysts (facet cysts). Ten-year experience in evaluation and treatment","volume":"20","author":"Hsu","year":"1995"},{"key":"b20-spine14996","series-title":"Surgeon","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1016\/S1479-666X(04)80074-X","article-title":"Intraspinal lumbar synovial cysts: diagnosis and surgical management","volume":"2","author":"Indar","year":"2004"},{"key":"b21-spine14996","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"527","DOI":"10.1148\/radiology.170.2.2911681","article-title":"Intraspinal synovial cysts: MR imaging","volume":"170","author":"Jackson","year":"1989"},{"key":"b22-spine14996","series-title":"J Spinal Disord Tech","doi-asserted-by":"publisher","first-page":"E13","DOI":"10.1097\/BSD.0b013e31822ac4e5","article-title":"Lumbar juxtafacet cyst resection: the facet sparing contralateral minimally invasive surgical approach","volume":"25","author":"James","year":"2012"},{"key":"b23-spine14996","series-title":"Eur Spine J","doi-asserted-by":"publisher","first-page":"1176","DOI":"10.1007\/s00586-005-0009-4","article-title":"Spinal lumbar synovial cysts. Diagnosis and management challenge","volume":"15","author":"Khan","year":"2006"},{"key":"b24-spine14996","series-title":"J Clin Neurosci","doi-asserted-by":"publisher","first-page":"694","DOI":"10.1016\/j.jocn.2005.09.013","article-title":"Lumbar juxta-facet cyst after trauma","volume":"13","author":"Kono","year":"2006"},{"key":"b25-spine14996","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"398","DOI":"10.3171\/spi.2006.5.5.398","article-title":"Facet cyst in the lumbar spine: radiological and histopathological findings and possible pathogenesis","volume":"5","author":"Kusakabe","year":"2006"},{"key":"b26-spine14996","series-title":"Neurosurg Rev","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1007\/s10143-011-0356-z","article-title":"Microsurgical excision without fusion as a safe option for resection of synovial cyst of the lumbar spine: long-term follow-up in mono-institutional experience","volume":"35","author":"Landi","year":"2012"},{"key":"b27-spine14996","series-title":"J Am Acad Orthop Surg","doi-asserted-by":"publisher","first-page":"194","DOI":"10.5435\/JAAOS-20-04-194","article-title":"Radiographic analysis of spondylolisthesis and sagittal spinopelvic deformity","volume":"20","author":"Li","year":"2012"},{"key":"b28-spine14996","series-title":"Clin Radiol","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1053\/crad.2001.0710","article-title":"Symptomatic lumbar synovial cyst: management with direct CT-guided puncture and steroid injection","volume":"56","author":"Lim","year":"2001"},{"key":"b29-spine14996","series-title":"AJR Am J Roentgenol","doi-asserted-by":"publisher","first-page":"163","DOI":"10.2214\/ajr.154.1.2104702","article-title":"Synovial cysts of the lumbosacral spine: diagnosis by MR imaging","volume":"154","author":"Liu","year":"1990"},{"issue":"1 Suppl","key":"b30-spine14996","series-title":"J Neurosurg","first-page":"53","article-title":"Surgical evaluation and management of lumbar synovial cysts: the Mayo Clinic experience","volume":"93","author":"Lyons","year":"2000"},{"key":"b31-spine14996","series-title":"J Bone Joint Surg Am","doi-asserted-by":"publisher","first-page":"891","DOI":"10.2106\/00004623-197153050-00004","article-title":"Negative disc exploration. An analysis of the causes of nerve-root involvement in sixty-eight patients","volume":"53","author":"Macnab","year":"1971"},{"key":"b32-spine14996","series-title":"Neuroradiology","doi-asserted-by":"publisher","first-page":"346","DOI":"10.1007\/BF00339570","article-title":"Intraspinal synovial cyst: diagnosis by CT. Follow-up and spontaneous remission","volume":"27","author":"Mercader","year":"1985"},{"key":"b33-spine14996","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1227\/00006123-198804000-00004","article-title":"Synovial cysts of the spine","volume":"22","author":"Onofrio","year":"1988"},{"key":"b34-spine14996","series-title":"Radiology","doi-asserted-by":"publisher","first-page":"509","DOI":"10.1148\/radiology.210.2.r99fe60509","article-title":"Symptomatic lumbar facet joint synovial cysts: clinical assessment of facet joint steroid injection after 1 and 6 months and long-term follow-up in 30 patients","volume":"210","author":"Parlier-Cuau","year":"1999"},{"key":"b35-spine14996","series-title":"World J Clin Cases","doi-asserted-by":"publisher","first-page":"285","DOI":"10.12998\/wjcc.v1.i9.285","article-title":"Midline synovial and ganglion cysts causing neurogenic claudication","volume":"1","author":"Pindrik","year":"2013"},{"key":"b36-spine14996","series-title":"Br J Neurosurg","doi-asserted-by":"publisher","first-page":"123","DOI":"10.3109\/02688697.2011.595847","article-title":"Spontaneous resolution of a symptomatic synovial cyst of the lumbar spine","volume":"26","author":"Pulhorn","year":"2012"},{"key":"b37-spine14996","series-title":"Br J Neurosurg","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1080\/02688699745673","article-title":"Synovial cysts of the lumbar spine: a review","volume":"11","author":"Radatz","year":"1997"},{"key":"b38-spine14996","series-title":"J Neurosurg Spine","doi-asserted-by":"publisher","first-page":"453","DOI":"10.3171\/2012.8.SPINE12101","article-title":"Minimally invasive resection of lumbar synovial cysts from a contralateral approach","volume":"17","author":"Rhee","year":"2012"},{"issue":"4","key":"b39-spine14996","series-title":"Neurosurg Focus","doi-asserted-by":"publisher","first-page":"E15","DOI":"10.3171\/2011.7.FOCUS11122","article-title":"Management of incidental durotomy in minimally invasive spine surgery","volume":"31","author":"Ruban","year":"2011"},{"key":"b40-spine14996","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"560","DOI":"10.3171\/jns.1996.85.4.0560","article-title":"A series of 60 juxtafacet cysts: clinical presentation, the role of spinal instability, and treatment","volume":"85","author":"Sabo","year":"1996"},{"key":"b41-spine14996","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1227\/01.NEU.0000097269.79994.2F","article-title":"Minimally invasive surgical treatment of lumbar synovial cysts","volume":"54","author":"Sandhu","year":"2004"},{"issue":"3","key":"b42-spine14996","series-title":"Neurosurg Focus","first-page":"E2","article-title":"Treatment of lumbar synovial cysts using minimally invasive surgical techniques","volume":"20","author":"Sehati","year":"2006"},{"key":"b43-spine14996","series-title":"J Neurol Surg A Cent Eur Neurosurg","first-page":"373","article-title":"The frequency of accidental dural tears in minimally invasive spinal fusion techniques","volume":"74","author":"Senker","year":"2013"},{"key":"b44-spine14996","series-title":"Spine J","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/S1529-9430(03)00148-7","article-title":"Lumbar intraspinal synovial cysts: conservative management and review of the world\u2019s literature","volume":"3","author":"Shah","year":"2003"},{"key":"b45-spine14996","series-title":"AJNR Am J Neuroradiol","first-page":"1261","article-title":"Spontaneous resolution of an intraspinal synovial cyst","volume":"24","author":"Swartz","year":"2003"},{"key":"b46-spine14996","series-title":"J Neurosurg","doi-asserted-by":"publisher","first-page":"449","DOI":"10.3171\/jns.1994.81.3.0449","article-title":"Hemorrhage into a lumbar synovial cyst causing an acute cauda equina syndrome. Case report","volume":"81","author":"Tatter","year":"1994"},{"key":"b47-spine14996","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1055\/s-0028-1082313","article-title":"Postoperative management of incidental durotomy in minimally invasive lumbar spinal surgery","volume":"51","author":"Than","year":"2008"},{"key":"b48-spine14996","series-title":"J Neurol Neurosurg Psychiatry","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1136\/jnnp.70.1.74","article-title":"Diagnosis and surgical management of intraspinal synovial cysts: report of 19 cases","volume":"70","author":"Trummer","year":"2001"},{"key":"b49-spine14996","series-title":"J Orthop Surg","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1186\/1749-799X-2-5","article-title":"Microdecompression for lumbar synovial cysts: an independent assessment of long term outcomes","volume":"2","author":"Weiner","year":"2007"},{"key":"b50-spine14996","series-title":"Spine (Phila Pa 1976)","doi-asserted-by":"publisher","first-page":"2689","DOI":"10.1097\/01.brs.0000244615.43199.07","article-title":"Microendoscopic discectomy for lumbar disc herniation: surgical technique and outcome in 873 consecutive cases","volume":"31","author":"Wu","year":"2006"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/23\/4\/article-p444.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/23\/4\/article-p444.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/23\/4\/article-p444.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T21:48:11Z","timestamp":1681595291000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/23\/4\/article-p444.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,10]]},"references-count":50,"journal-issue":{"issue":"4"},"URL":"https:\/\/doi.org\/10.3171\/2015.1.spine14996","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2015,10]]}}}