I see a lot of facet cysts in the lumbar spine in my practice. Typically, it is due to a subtle instability of the motion segment, usually at L4-5 when there is a spondylolisthesis. Facet cysts are like the ganglion cyst in your wrist or the Baker’s cyst in the back of your knee, except that when they start to get large, they will pinch the nerves going by it, causing sciatica as well as arthritic back pain. The traditional treatment is to remove the entire facet joint, but then you must do a FUSION because for the cyst to develop, it’s usually due to some subtle instability. When we do surgery, we increase that instability because we are disrupting the surrounding structures. So, if you want to remove a facet cyst without doing a fusion, you want to do it as minimally invasively as possible so that you do not introduce any additional instability into an already unstable motion segment. That’s why the LESS (laser endoscopic spine surgery) procedure is so perfect for a patient that has primarily leg pain and refuses a FUSION (the F word in spine medicine).
Medical Disclaimer: The information in this video is not intended to serve as professional medical advice, diagnosis, or treatment. To address your specific medical concerns, we strongly recommend that you consult with your healthcare provider. The surgical procedures shown in this video are performed by a qualified spine surgeon and may not be appropriate for all individuals. Permission has been granted by all patients in this surgical footage for filming during their procedures and sharing on social media platforms.
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