Symptomatic lumbar facet joint synovial cysts: Clinical assessment of facet joint steroid injection after 1 and 6 months and long-term follow-up in 30 patients

PURPOSE: To study the results of facet joint intraarticular steroid injecti ons in patients with symptomatic lumbar facet joint synovial cysts. MATERIALS AND METHODS: Data from 30 patients (age range, 44-82 years; mean age, 67 years) with nerve root pain due to a lumbar facet joint synovial cy st and treated with facet joint steroid injection were retrospectively stud ied. On the basis of MacNab criteria, the clinical course of nerve root pai n was evaluated after 1 (n = 30) and 6 (n = 28) months. Data from long-term follow-up (mean, 26 months) were also available in 14 nonsurgically treate d patients. RESULTS: After 1 month, the nerve root pain outcome was excellent or good i n 20 patients (67%) and fair or poor in 10 (33%). After 6 months, 10 (50%) of these 20 patients still had excellent or good results, and 18 (60%) of t he 30 patients had a fair or poor clinical status, 14 of whom underwent sur gery; two patients (7%) were lost to follow-up. Excellent and good results were maintained at further follow-up (range, 9-50 months). CONCLUSION: One-third of patients with symptomatic lumbar facet joint synov ial cysts had long-lasting acceptable benefit from facet joint steroid inje ctions in this study. Steroid injection should be indicated before surgery.