腰椎椎弓切除後に発生した椎間関節近傍囊腫

抄録

  Finding Juxta facet cyst is not rare in the era of magnetic resonance imaging (MRI) but little is known regarding cyst formation following lumbar laminectomy. Between 2010 and 2017, we performed lumbar laminectomy on 264 patients. Lumbar laminectomy was performed for either lumbar canal stenosis (n=221) or degenerative spondylolisthesis (n=43). Postoperative MR images were obtained from patients who developed recurrent lumbar pain or leg pain. Juxta facet cysts were diagnosed by MR images. The images demonstrated cyst formation adjacent to the facet joint with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. Nine patients (3.3%) were found to have developed juxta facet cysts after lumbar laminectomy. The incidence of cyst formation was higher in the patients with degenerative spondylolisthesis (n=4, 9.3%) than in patients with lumbar canal stenosis (n=5, 2.3%). All patients were managed conservatively by medication and/or nerve root block and eight out of nine patients showed resolution of recurrent pain in a few months. The cysts disappeared in four patients as seen in MR images. Juxta facet cyst development following lumbar laminectomy is likely due to facet joint degeneration. The facet joint is covered with ligamentum flavum and injury to the ligamentum during the surgical procedure may accelerate joint degeneration postoperatively.