Endoscopic resection of symptomatic lumbar juxtafacet cysts: clinical outcomes, complications, and recurrence in a single-center retrospective study
Year: 2026
Type: article
Abstract: Background: Lumbar juxtafacet cysts are degenerative extradural lesions associated with facet arthropathy and segmental instability that may cause radiculopathy, low back pain, neurogenic claudication, and neurological deficit. Full-endoscopic resection may provide direct neural decompression while limiting disruption of posterior stabilizing structures. This study evaluated clinical outcomes, complications, symptomatic recurrence, and patient satisfaction after endoscopic resection of symptomatic lumbar juxtafacet cysts. Methods: This single-center retrospective study analyzed prospectively collected data from consecutive adults who underwent endoscopic cyst resection. In patients without motor deficit, surgery was indicated for persistent, functionally limiting symptoms despite at least 3 months of conservative treatment, whereas earlier intervention was considered in patients with motor deficit. Preoperative radiographs were assessed for spondylolisthesis and segmental instability, and isolated endoscopic resection was reserved for patients without an indication for fusion. Clinical outcomes included visual analogue scale (VAS) scores for leg and low back pain and the Oswestry Disability Index (ODI). Complications, symptomatic same-level recurrence, operative time, motor recovery, and patient satisfaction were recorded. Mean follow-up was 19.6 months. Results: Twenty-one consecutive patients underwent endoscopic cyst resection; 6 were lost to follow-up, leaving 15 patients for final analysis. Ten patients (66.7%) had no spondylolisthesis or segmental instability, whereas 5 (33.3%) had Meyerding grade I spondylolisthesis. Mean VAS leg pain improved from 7.3±2.79 to 3.8±2.83 (P=0.002), mean VAS low back pain from 7.7±2.87 to 2.1±2.83 (P=0.002), and mean ODI from 42.1±14.55 to 20.7±17.05 (P=0.001). Mean operative time was 110.0±34.4 minutes, and all patients were mobilized on the day of surgery and discharged within 24 hours. One intraoperative dural tear occurred (6.7%) and was repaired endoscopically without postoperative cerebrospinal fluid leakage or further intervention. Increased back pain and leg dysesthesia each occurred in 2 patients (13.3%); these symptoms were managed conservatively and resolved by 6 months. All 4 patients with preoperative motor deficits improved at final follow-up. No symptomatic same-level recurrence was identified. Thirteen patients (86.7%) were satisfied, 11 (73.3%) would recommend the procedure, and 12 (80.0%) would undergo it again if needed. Conclusions: In this selected cohort, endoscopic resection was associated with significant improvement in pain and disability, high patient satisfaction, and no symptomatic clinical recurrence at a mean follow-up of 19.6 months. These findings support full-endoscopic resection as a minimally invasive, structure-preserving option in appropriately selected patients. Because of the small sample size and absence of routine postoperative imaging, uncommon complications and asymptomatic radiographic recurrence cannot be excluded. Larger prospective comparative studies with standardized radiographic follow-up are warranted.
Source: Journal of Spine Surgery
Language: English
Subfield: Orthopedics and Sports Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7223860697