Article
Cervical Juxta-facet cysts – clinical presentation and functional outcome in a single-institution experience
Zervikale Facettengelenkszysten – klinische Symptomatik und funktionelles ,Outcome‘ – eine Single-Center-Studie
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Authors
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Wael Dahy Morsy Ahmed
- Universitätsklinikum Tübingen, Neurochirurgie, Tübingen, Deutschland; Sohag University Hospitals, Department of Neurosurgery, Sohag, Ägypten
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Sasan Darius Adib
- Universitätsklinikum Tübingen, Neurochirurgie, Tübingen, Deutschland
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Marcos Tatagiba
- Universitätsklinikum Tübingen, Neurochirurgie, Tübingen, Deutschland
| Published: | June 4, 2021 |
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Outline
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Objective: Cervical juxta-facet cysts (JFC) are rare but important differential diagnosis in spinal degenerative diseases. Patients’ demographic features, clinical and imaging characteristics, treatment options and outcomes are important variables, which have been discussed through few numbers of publications. This study aims to report our institute experience with cervical JFC, hoping to better define these variables and increase the literature knowledge.
Methods: This study retrospectively reviewed cases of 11 patients with JFC, treated in our institute from 2005 to 2020. Patients’ age, sex, cervical level, clinical presentation, imaging, intraoperative findings, treatment strategy and outcomes were obtained from medical reports and analyzed. This cohort study was approved by the local ethical committee.
Results: Out of 378 patients with JFC who had been treated in our institute, there were 11 patients (2.9 %) (6 men and 5 women) having JFC in the cervical region. Patients’ age ranged from 54 - 84 years. The most common cervical level was C7-T1 (72.7 %). Only 9% of cases had bilateral cysts. The most frequent clinical presentations were: Radiculopathy (100%), sensory deficit (90.1%), motor deficit (63.6%), while axial neck pain and myelopathy occurred in 45.5% and 36.4%, respectively. The follow up period ranged from 6 - 72 months. Surgery was the main treatment strategy in 90.9 % (10 pt.). Only 1 patient had conservative treatment Fusion was required in 70% of cases (60% initial and 10% delayed), while microsurgical excision alone was enough in 30%. All cases had complete clinical improvement after surgery. Cyst recurrence occurred in one patient. Patients' satisfaction on Macnab classification was excellent and good in 90 % of cases.
Conclusion: This study advocates for early surgery rather than prolonged conservative treatment. Dynamic imaging is very important before and after surgery to identify instability. High fusion rate in cervical region reflects hypermobility of this region, especially the junctional level C7-T1 (where most cases occur).This study also reflects the rarity of these lesions (only 11 patients over a time period of 15 years), so further prospective studies with longer follow up are needed to corroborate these findings.
