Three cases of lumbar facet joint cyst successfully treated by facet joint arthrography and steroid injection

Abstract

We encountered 3 cases of lumbar facet joint cyst, which were successfully treated by facet joint arthrography and subsequent steroid injection. On magnetic resonance imaging (MRI), we observed nerve root compression due to the cysts. The area of the pain and the nerve root compression findings on MRI were neurologically consistent. Arthrography confirmed the inflow of contrast medium from the facet joint to the cyst. In all the cases, lower limb pain was induced at the time of pressure injection into the facet joint. In 2 cases, the cyst ruptured on contrast medium injection, following which, steroid was injected; in 1 case, the cysts did not rupture following contrast medium injection. However, the pain improved dramatically in all patients. No patient presented with cyst recurrence even after 6 months. Facet joint arthrography followed by steroid injection appears to be an effective alternative to surgery in the treatment of facet joint cysts.