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Should We Label All Synovial Cysts as Unstable?
STUDY DESIGN: Retrospective study. OBJECTIVE: To analyze the various anatomical parameters that influence segmental stability in patients suffering from lumbar intra spinal cysts (LISCs) and to determine the outcome of microscopic unilateral laminotomy and cystectomy. METHODS: All patients that were...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624374/ https://www.ncbi.nlm.nih.gov/pubmed/28989841 http://dx.doi.org/10.1177/2192568217700103 |
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author | Kulkarni, Arvind G. Dutta, Shumayou Dhruv, Abhilash Bassi, Anupreet |
author_facet | Kulkarni, Arvind G. Dutta, Shumayou Dhruv, Abhilash Bassi, Anupreet |
author_sort | Kulkarni, Arvind G. |
collection | PubMed |
description | STUDY DESIGN: Retrospective study. OBJECTIVE: To analyze the various anatomical parameters that influence segmental stability in patients suffering from lumbar intra spinal cysts (LISCs) and to determine the outcome of microscopic unilateral laminotomy and cystectomy. METHODS: All patients that were surgically managed for a LISC between 2007 and 2013 with more than 3 years of follow-up were reviewed. Those without associated instability were evaluated for segmental mobility, segmental angulation, facet inclination, stage of disc degeneration, and level of involvement on MRI and dynamic radiographs. Outcomes of unilateral laminotomy and cystectomy were evaluated using VAS (Visual Analogue Score), ODI (Oswestry Disability Index), and Macnabs criteria. Dynamic radiographs were performed in all cases pre- and postoperatively and at the last follow-up. RESULTS: Thirty patients were operated for a LISC between 2007 and 2013. The levels involved were L4-5(23), L3-4(4) and L5-S1(3). The mean facet angle was 42.6 (± 6.1) degrees. The stage of disc degeneration was scattered haphazardly across all the cases (Gr 2[17]; Gr 3[1]; Gr 4[8]; Gr 5[4]). VAS and ODI scores improved significantly in all patients. Mean follow-up was 46.5 months (36-96 months). No patient developed postoperative instability at the last follow-up. CONCLUSIONS: The coronal inclination of the facet joints, absence of radiological instability, and poor co-relation with stages of disc degeneration suggests the presence of adequate residual stability. In this study, stand-alone decompression for LISCs without instability had well sustained good/excellent outcomes. Fusion is recommended for LISCs with associated instability. |
format | Online Article Text |
id | pubmed-5624374 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-56243742017-10-06 Should We Label All Synovial Cysts as Unstable? Kulkarni, Arvind G. Dutta, Shumayou Dhruv, Abhilash Bassi, Anupreet Global Spine J Original Articles STUDY DESIGN: Retrospective study. OBJECTIVE: To analyze the various anatomical parameters that influence segmental stability in patients suffering from lumbar intra spinal cysts (LISCs) and to determine the outcome of microscopic unilateral laminotomy and cystectomy. METHODS: All patients that were surgically managed for a LISC between 2007 and 2013 with more than 3 years of follow-up were reviewed. Those without associated instability were evaluated for segmental mobility, segmental angulation, facet inclination, stage of disc degeneration, and level of involvement on MRI and dynamic radiographs. Outcomes of unilateral laminotomy and cystectomy were evaluated using VAS (Visual Analogue Score), ODI (Oswestry Disability Index), and Macnabs criteria. Dynamic radiographs were performed in all cases pre- and postoperatively and at the last follow-up. RESULTS: Thirty patients were operated for a LISC between 2007 and 2013. The levels involved were L4-5(23), L3-4(4) and L5-S1(3). The mean facet angle was 42.6 (± 6.1) degrees. The stage of disc degeneration was scattered haphazardly across all the cases (Gr 2[17]; Gr 3[1]; Gr 4[8]; Gr 5[4]). VAS and ODI scores improved significantly in all patients. Mean follow-up was 46.5 months (36-96 months). No patient developed postoperative instability at the last follow-up. CONCLUSIONS: The coronal inclination of the facet joints, absence of radiological instability, and poor co-relation with stages of disc degeneration suggests the presence of adequate residual stability. In this study, stand-alone decompression for LISCs without instability had well sustained good/excellent outcomes. Fusion is recommended for LISCs with associated instability. SAGE Publications 2017-05-31 2017-10 /pmc/articles/PMC5624374/ /pubmed/28989841 http://dx.doi.org/10.1177/2192568217700103 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc-nd/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Articles Kulkarni, Arvind G. Dutta, Shumayou Dhruv, Abhilash Bassi, Anupreet Should We Label All Synovial Cysts as Unstable? |
title | Should We Label All Synovial Cysts as Unstable? |
title_full | Should We Label All Synovial Cysts as Unstable? |
title_fullStr | Should We Label All Synovial Cysts as Unstable? |
title_full_unstemmed | Should We Label All Synovial Cysts as Unstable? |
title_short | Should We Label All Synovial Cysts as Unstable? |
title_sort | should we label all synovial cysts as unstable? |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624374/ https://www.ncbi.nlm.nih.gov/pubmed/28989841 http://dx.doi.org/10.1177/2192568217700103 |
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