Evidence that atypical juxtafacet cysts are joint derived: Clinical article

Robert J. Spinner, Marie Noëlle Hébert-Blouin, Timothy Maus, John L D Atkinson, Nicholas M. Desy, Kimberly K. Amrami

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Object. Juxtafacet cysts (JFCs) in usual locations have recently been shown to have joint connections. The pathogenesis of JFCs in unusual locations has remained obscure. The authors hypothesize that all JFCs, including atypical ones, are joint derived. Methods. In this study the authors sought to explain the occurrence and formation of clinical outliers of spinal JFCs. In Part I, they performed an extensive literature search to identify case reports of spinal intraneural cysts that have been unappreciated despite the fact that they should occur. In Part II, they studied far-lateral (extraforaminal) cysts treated at their institution and reported in the literature. The presence of a joint connection was specifically looked for since this finding has not been widely appreciated. Results. In Part I, 3 isolated case reports of spinal intraneural JFCs without reported joint connections were identified: 2 involving L-5 and 1, C-8. In Part II, 6 cases involving patients with far-lateral JFCs treated at the authors' institution were reviewed and all 6 had joint connections. Two of these cases had been previously published, although their joint connections were not appreciated. In 2 of the newly reported cases, arthrography confirmed a communication between the facet and the cyst. Only 1 of 5 cases in the literature had a recognized joint connection. Conclusions. The authors believe that all JFCs are joint derived. This explanation for intraneural and extraneural JFCs in typical locations would be consistent with the unified articular (synovial) theory and the pathogenesis for intraneural and extraneural ganglion cyst formation in the limbs. Facet joints appear no different from other synovial joints occurring elsewhere. Understanding the pathogenesis of these cysts will help target treatment to the joint, improve surgical outcomes, and decrease recurrences.

Original languageEnglish (US)
Pages (from-to)96-102
Number of pages7
JournalJournal of Neurosurgery: Spine
Volume12
Issue number1
DOIs
StatePublished - Jan 2010

Fingerprint

Cysts
Joints
Periodontal Cyst
Ganglion Cysts
Zygapophyseal Joint
Arthrography
Extremities
Communication
Recurrence

Keywords

  • Cyst
  • Facet
  • Ganglion
  • Intraneural ganglion
  • MR imaging
  • Unified theory

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery
  • Neurology

Cite this

Spinner, R. J., Hébert-Blouin, M. N., Maus, T., Atkinson, J. L. D., Desy, N. M., & Amrami, K. K. (2010). Evidence that atypical juxtafacet cysts are joint derived: Clinical article. Journal of Neurosurgery: Spine, 12(1), 96-102. https://doi.org/10.3171/2009.7.SPINE09257

Evidence that atypical juxtafacet cysts are joint derived : Clinical article. / Spinner, Robert J.; Hébert-Blouin, Marie Noëlle; Maus, Timothy; Atkinson, John L D; Desy, Nicholas M.; Amrami, Kimberly K.

In: Journal of Neurosurgery: Spine, Vol. 12, No. 1, 01.2010, p. 96-102.

Research output: Contribution to journalArticle

Spinner, RJ, Hébert-Blouin, MN, Maus, T, Atkinson, JLD, Desy, NM & Amrami, KK 2010, 'Evidence that atypical juxtafacet cysts are joint derived: Clinical article', Journal of Neurosurgery: Spine, vol. 12, no. 1, pp. 96-102. https://doi.org/10.3171/2009.7.SPINE09257
Spinner, Robert J. ; Hébert-Blouin, Marie Noëlle ; Maus, Timothy ; Atkinson, John L D ; Desy, Nicholas M. ; Amrami, Kimberly K. / Evidence that atypical juxtafacet cysts are joint derived : Clinical article. In: Journal of Neurosurgery: Spine. 2010 ; Vol. 12, No. 1. pp. 96-102.
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