Variety of Techniques Effective for Treating Spinal Synovial Cysts
(HealthDay News) – For patients with spinal synovial cysts, the majority who undergo surgery have excellent or good outcomes, according to a study published online Sept 6 in the Journal of Spinal Disorders & Techniques.
Steven Knafo, MD, of the Université of Paris-Descartes, and associates conducted a retrospective review of 23 patients with spinal synovial cysts who underwent surgery at a single institution between 2004 and 2010. Four categories of surgical procedures were examined: cystectomy via an inter-laminar approach (11 patients), via hemi-laminectomy (eight patients), via laminectomy (two patients), or associated with instrumented spinal fusion (two patients), and outcomes were compared between the groups.
The researchers found that 16 patients (69.6%) achieved excellent or good clinical outcomes on the Macnab modified scale. Two perioperative complications, two cyst recurrences, and one secondary fusion occurred. In a review of 519 patients reported in the literature, 83% had excellent or good clinical outcome. Unfavorable outcome was significantly more likely in patients treated with decompression alone (20.2 vs. 8.1%; P=0.003), as was cyst recurrence (P=0.028). In the fusion versus the decompression alone group, the rate of perioperative complications was significantly higher (18.7 vs. 2.8%; P<0.0001).
"In the end, it will be a mixture of clinical judgment and evidence-based knowledge that will lead to the right decision for a given patient over which technique should be used and even whether the patient should be operated [on] in the first place," the authors write.