What is a facet joint cyst?
A facet joint cyst is a fluid-filled sac that is an out-pouching of the capsule that surrounds the facet joints. Facet joint cysts are typically found in the lumbar spine and are most often related to degeneration. The facet joint cysts can be present in the neuroforaminal space or in the extra-foraminal area. When the cyst is located in the neuroforaminal space, patients may experience radicular legs symptoms and discomfort. When the cyst is located outside the neuroforaminal space they are relatively benign and do not cause significant pain.
What are the treatment options for a facet joint cyst?
Depending on the size of the cyst, physical therapy may be helpful to help stabilize the spine and remove imbalances in the posterior elements (facet joints) of the spine. The therapist may work on a core strengthening program. Weight loss may help to further remove pressure on the spine and the facet joints. In some instances, facet cysts can be injected and drained but the chance of recurrence is relatively high and the aspiration may not work as the fluid can be very loculated and thick making aspiration difficult or impossible. If conservative measures fail, corticosteroid injections can be injected into the epidural space to help alleviate any inflammation on and around the nerve to decrease the pain associated with an intraforaminal facet cyst. In some instances, surgery may be necessary.