PMC9663226_01
Preoperative magnetic resonance imaging (MRI) scan. This sagittal T2-weighted MRI image shows a hyperintense cystic lesion on the left side at the L4-5 level.
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However, its wall was thicker, and its internal content was clearer than before (Figure 1).
Preoperative magnetic resonance imaging (MRI) scan. This coronal T2-weighted MRI image shows cystic lesions on both sides, with each lesion arising from the right L4-5 facet joint.
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Together, these had caused mild central canal stenosis and severe left L5 lateral recess stenosis, with left L5 traversing nerve root compression (Figures 2 and 3).
Preoperative magnetic resonance imaging (MRI) scan. This axial T2-weighted MRI image shows a cystic lesion (red arrow) arising from the right L4-5 facet joint, causing the narrowing of the right neural foramina. Bilateral facet synovial cysts are also evident.
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Together, these had caused mild central canal stenosis and severe left L5 lateral recess stenosis, with left L5 traversing nerve root compression (Figures 2 and 3).
Preoperative magnetic resonance imaging (MRI) scan. This sagittal T2-weighted MRI image shows a hyperintense cystic lesion on the right side at the L4-5 level.
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Its size was unchanged at approximately 0.5 cm (Figure 4), causing right lateral recess stenosis with right L5 traversing nerve root compression.
Preoperative X-ray film. These anteroposterior and lateral views reveal grade 1 spondylolisthesis of L4 over L5.
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There was also a grade 1 spondylolisthesis of L4 over L5 (Figure 5).
Preoperative X-ray films. No further instability of L4 over L5 is evident in upright lateral flexion and extension views.
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Upright lateral flexion and extension X-rays of lumbosacral spine showed no further instability of L4 over L5 (Figure 6).
(a) Intraoperative image. It shows the removal of the facet cyst (black arrow) alongside the neural structure ( ). (b) Intraoperative image. No neural structure compression remains after cyst removal ( ).
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There was more adhesion to the thecal sac on its left side than on its right side (Figures 7(a) and 7(b)).
Postoperative X-ray films at the 1-year follow-up. Increased instability is not apparent in either the anteroposterior or the lateral view.
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Postoperative lumbosacral spine X-ray films and MRI at 1 year showed no further increase in segmental instability (Figure 8) and the absence of bilateral cysts (Figures 9 and 10).
Postoperative magnetic resonance imaging (MRI) scan at the 1-year follow-up. This axial T2-weighted MRI image confirms the absence of bilateral cysts.
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Postoperative lumbosacral spine X-ray films and MRI at 1 year showed no further increase in segmental instability (Figure 8) and the absence of bilateral cysts (Figures 9 and 10).
Postoperative magnetic resonance imaging (MRI) scan at the 1-year follow-up. This sagittal T2-weighted MRI image confirms the absence of bilateral cysts.
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Postoperative lumbosacral spine X-ray films and MRI at 1 year showed no further increase in segmental instability (Figure 8) and the absence of bilateral cysts (Figures 9 and 10).