Percutaneous resolution of lumbar facet joint cysts as an alternative treatment to surgery: a meta-analysis

Lumbar facet joint cysts (LFJC), associated with lower back and radicular pain, have been clinically treated with an array of strategies. The prevalence of LFJCs is greatest in the latter decades of life, and LFJCs are associated with neurogenic claudication and spinal stenosis (1). As LFJCs rarely resolve without intervention, management may involve non-steroidal anti-inflammatory drugs, analgesics, intra-articular steroid injections and fluoroscopy-guided needle aspiration. LFJCs are also frequently treated through surgical interventions such as laminectomy, facetectomy, flavectomy and cyst excision (2). These surgical procedures currently provide the most successful long-term symptomatic relief (3). However, percutaneous resolution can be an effective alternative treatment strategy in a large sub-group of patients (4). Furthermore, percutaneous treatment may be advantageous to elderly and high-risk patients. Shuang et al. (5) recently published a systematic review and meta-analysis to assess the use of percutaneous resolution to treat LFJCs. Here we describe their study and comment on/discuss the limitations and clinical implications of their findings.