Computed Tomography-Guided Facet Synovial Cyst Aspiration

Abstract Lumbar facet joint cysts are the benign collections of fluid at or around the facet joints, which may lead to pain and radicular symptoms. They may be associated with spinal stenosis, nerve root compression, neurogenic claudication, and many other neurological disturbances, as they can encroach on the adjacent neural foramen. Although the recommended treatment is surgical excision, percutaneous interventions provide an effective, acceptable, and safe alternative that may be considered. Hereby, we present the case of a 78-year-old patient known diabetic, hypertensive, and with deranged renal function, with left-sided L5 radiculopathy due to an L4-5 facet synovial cyst. He was treated through computed tomography (CT)-guided percutaneous aspiration and got long-term relief. The technique we used was different from the regular facet cyst aspiration, and the precision offered by CT guidance helped us provide optimum treatment leading to long-term relief. Thus, tailor-made treatment options rather than standard protocols for all patients allow a better risk–benefit ratio, in the field of pain management.