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A 60-year-old male has right leg radicular pain with hip abductor and EHL weakness. An MRI is shown in figures A-C. What is the source of this patient's symptoms?
paracental disk herniation
far lateral disk herniation
facet synovial cyst
hypertrophic ligamentum flavum
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Juxtafacet cysts are uncommon causes of radicular pain and are often associated with significant spinal degenerative disease. Previous studies have not focused on the outcome of patients who have undergone resection. Banning et al performed a retrospective review of patients who underwent lumbar juxtafacet cyst resection. Thirty-three lumbar juxtafacet cysts were resected from 29 patients. Cysts most commonly arose at the L4-L5 level (51%). Incidental durotomy was the most common surgical complication occurring in 3 cases (9%). Twenty patients (83%) reported improvement in pain, and 16 (67%) reported an improved level of function. All respondents reported some degree of improvement in their condition after surgery. They recommend surgical resection as the treatment of choice with low rates of complications, recurrences, and residual complaints.
Illustration A highlights the facet synovial cyst demonstrated in Figure C
Banning CS, Thorell WE, Leibrock LG
Spine. 2001 Apr;26(8):969-72. PMID: 11317123 (Link to Abstract)
Banning, SPINE 2001
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