Interventions for Lumbar Synovial Facet Joint Cysts: Comparison of Percutaneous, Surgical Decompression and Fusion Approaches Systematic Review and Meta-Analysis

Abstract

Background: Lumbar facet cysts are a rare but increasingly common cause of symptomatic nerve root compression and can lead to radiculopathy, neurogenic claudication, and cauda equina syndrome. Aim of the Work: The present systematic review aims to illustrate the clinical and radiological outcomes when using percutaneous versus surgical decompression of lumber synovial facet joint cysts with or without fusion. Material and Methods: A total of 16 studies were included for the final qualitative and quantitative analysis in the current systematic review. The overall quality was moderate to high quality regarding the quality of both RCTs and observational studies. Results: Twelve of the included studies reported the outcome of reoperation rate after surgical decompression procedure for lumber synovial facet joint cysts. The pooled analysis of the included studies showed a significant decrease in reoperation rate after surgical decompression regarding the synovial facet joint cyst favoring the surgical decompression technique over the percutaneous technique. Seven of the included studies reported the outcome of reoperation rate after percutaneous procedure for lumber synovial facet joint cysts. The pooled analysis of the included studies showed no significant decrease in reoperation rate after percutaneous procedure regarding the synovial facet joint cyst favoring the surgical decompression technique over the percutaneous technique. Conclusion: The surgical decompression technique is a favored intervention for lumbar synovial facet joint cysts over the percutaneous technique regarding the postoperative resolution and recurrence rate.