PMC6453832_01
A) Pre-operative MRI (sagittal-top, axial-bottom) demonstrates bilateral juxtafacet cysts (left > right). B) Pre-operative CT (sagittal-top, axial-bottom) shows calcification of the smaller right-sided cyst.
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As shown in Fig. 1, lumbar MRI demonstrated severe thecal sac stenosis at L3-L4 secondary to bilateral, left greater than right juxtafacet cysts causing compression of the cauda equina nerve roots.
Intraoperative view prior to ILD placement at the completion of partial L3 and L4 laminectomies, bilateral cyst resection, and mesial facetectomies showing a decompressed thecal sac.
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Decompression of the thecal sac at L3-4 was accomplished via partial inferior L3 and superior L4 laminectomies and mesial facetectomies via a standard midline approach in the usual fashion (Fig. 2).
A) Post-operative X-Rays (lateral-top, antero-posterior-bottom) showing ILD at L3-4 obtained on post-operative day 1. B) 6-month post-operative CT (sagittal-top, axial-bottom) shows hardware in place with no evidence of cyst recurrence.
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Fig. 3 demonstrates post-operative standing films and 6-month post-operative CT.