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Vol. 12. Issue 4.
Pages 308-315 (January 2001)
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Vol. 12. Issue 4.
Pages 308-315 (January 2001)
Compresión radicular lumbar secundaria a quistes yuxtafacetarios: revisión de 10 casos
Lumbar radicular compression secondary to juxtafacet cysts: report of ten cases
Visits
2341
C. Hostalot
, G. Bilbao, I. Pomposo, J. Aurrekoetxea, L.M. Canales, J. Zorrilla
Servicio de Neurocirugía. Hospital de Cruces. Bizkaia
M. Mozas*, M. Urigüen**, A. Pastor***, J. Garibi**
* Servicio de Anestesiología y Reanimación. Hospital de Cruces. Bizkaia
** Departamento de Cirugía, Medicina Física y Radiología de la Universidad del País Vasco. Bizkaia
*** Servicio de Neurorradiología. Hospital de Cruces. Bizkaia
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Resumen
Objetivo

Se presenta una revisión de la clínica, estudios radiológicos, y hallazgos operatorios e histológicos de 10 pacientes con 11 quistes yuxtafacetarios de la columna lumbar tratados en nuestro centro desde 1994 al 2000.

Métodos

Se han analizado las historias clínicas, imágenes radiológicas, protocolos quirúrgicos e informes histopatológicos de los 10 pacientes diagnosticados de quiste yuxtafacetario lumbar (11).

Resultados

Seis pacientes eran mujeres y cuatro hombres. La edad media de presentación fue de 54 años. La clínica de más frecuente presentación fue la de dolor radicular, siendo poco común el déficit motor o sensitivo. La tomografía computerizada y la resonancia magnética son esenciales para establecer el diagnóstico. Los quistes estaban localizados a nivel L4–L5 en ocho pacientes, a nivel L2–L3 en un paciente y L3–L4 en otro paciente. Ocho pacientes se trataron mediante laminec-tomía descompresiva y resección del quiste, y los dos restantes recibieron tratamiento conservador. Fenómenos degenerativos adyacentes a los quistes yuxtafacetarios son fáciles de evidenciar. Todos los pacientes han presentado mejoría de su dolor radicular.

Conclusiones

Analizando nuestra casuística, concluimos que los quistes yuxtafacetarios aparecen más frecuentemente a nivel L4–L5, sobre todo en personas de edad avanzada, y producen habitualmente lumbalgia y radiculopatía. Aunque pueden tratarse de forma inicial-mente conservadora, ante un síndrome ciático progresivo, es preferible optar por un tratamiento quirúrgico.

Palabras clave:
Quiste yuxtafacetario
Quiste sinovial
Ganglión quístico
Articulación facetaría
Columna vertebral
Summary
Object

We report a series of 10 patients with 11 juxtafacet cysts of the lumbar spine treated in our center from 1994 to 2000.

Methods

The clinical histories, radiographic images, surgical protocols and pathological records of the 10 patients diagnosed of lumbar juxtafacet cyst have been analyzed.

Results

Six patients were women and four were men. The average age of presentation was 54 years. The most frequent clinical presentation was radicular pain, and motor or sensitive deficits were not very common. Computed tomography and magnetic resonance are éssential in establishing the diagnosis. The cysts were located at L4–L5 in eight patients, at L2–L3 in one patient, and at L3–L4 in other patient. Eight patients were treated by means of decompressive laminectomy and excision of the cyst, and the remaining two.underwent conservative treatment. Degenerative phenomena adjacent to the juxtafacet cysts are easy to evidence. All the patients were improved of their radicular pain.

Conclusions

Analysing our series, we conclude that the juxtafacet cysts appear more frequently at L4–L5 level in people of advanced age, and produce commonly low back pain and radiculopathy. Although they can be treated initially in a conservative way, in the presence of a progressive sciatic syndrome, surgical management is preferable.

Key words:
Juxtafacet cyst
Synovial cyst
Ganglion cyst
Facet joint
Spine

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