Facet Joint Cyst: Also called ZYGAPOPHYSEAL JOINTS. The facet joints are formed by the articular processes of adjacent vertebrae. The inferior articular process of a vertebra articulates with the superior articular process of the vertebra below. These are synovial gliding joints. Facet joints are oriented in different planes depending on their anatomic location.

1. Facet Joint Cyst
Dr Tejasvi Agarwal
Consultant Spine Surgeon
Get Well Spine

2. Facet Joint
 Also called ZYGAPOPHYSEAL
JOINTS.
 The facet joints are formed by the
articular processes of adjacent
vertebrae.
 The inferior articular process of a
vertebra articulates with the
superior articular process of the
vertebra below.
 These are synovial gliding joints.
 Facet joints are oriented in
different planes depending on
their anatomic location.

4. Synovial Facet Cyst
 A degenerative lesion of the lumbar spine that often
presents with radicular symptoms.
 Epidemiology: Rare
 Location: most commonly in lumbar: 60-89% at L4-L5.
 Lumbar facet synovial cyst was first described in 1968
by Kao et al.

5.  These cyst developed as a result of arthritic and
degenerative changes of facet joint leading to capsular
lesion and herniation of synovial membrane.
 Another reason is the mechanical load on the lumbar
spine and the site of maximum mobility.

6. Presentation
 Intermittent low back pain
 Radicular symptoms(leg pain)
 Neurogenic claudication.

7. Imaging
 Plain X-ray has a little role in the diagnosis, but they
are useful in excluding spondylosis, degenerative
spondylolisthesis and other lytic lesions.
 MRI is the imaging modality of choice for the diagnosis
of synovial cyst with the sensitivity of 77%.
 On MRI, it is seen as well circumscribed, smooth,
extradural lesion adjacent to facet joints with
low-intensity signal in T1-weighted and high-intensity
signal in T2-weighted images.

11. Management
 The management of symptomatic cyst is still debated.
 Various management options include conservative
treatment with bed rest, analgesics, brace, steroid injection,
and cyst aspiration.
 The reports of conservative treatment are disappointing.
 Very few studies reported complete resolution of cyst
spontaneously.
 Synovial cysts not responding to conservative treatment with
persistent radicular leg pain should be treated surgically.
 Surgical excision is the gold standard of treatment.
Resection and decompression with or without fusion or
instrumentation are other treatment options

12. Thank you