Minimally invasive surgical treatment of lumbar XXXX .

@entity1 @entity190 @entity12897 @entity3178 @entity615 @entity614 @entity130 @entity7443
OBJECTIVE: @entity12897 are a rare cause of @entity614 and @entity615 . Surgical treatment is directed at complete excision of the cyst. We used minimally invasive surgical techniques for a series of @entity1 , to assess the effectiveness of this approach for resection of @entity12897 . METHODS: Seventeen @entity1 (10 female and 7 male @entity1 ) with presumed @entity12897 , as indicated on magnetic resonance imaging scans, underwent surgical resection with the 18-mm METRx tubular retractor system (Medtronic Sofamor Danek, Memphis, @entity7443 ). A unilateral approach was used, with either an operating @entity3178 (13 cases) or a magnifying endoscope (4 cases), depending on the preference of the surgeon. Outcomes were reported by using modified MacNab criteria. RESULTS: The average @entity1 age was 64 years (range, 46-82 yr). The L4-L5 level was most commonly affected (82% of cases). Grade 1 spondylolisthesis at the level harboring the synovial cyst was observed for 47% of the @entity1 ; all cases of spondylolisthesis involved the L4-L5 level. The mean operative time was 97 minutes, and the average @entity190 was 35 ml. Excellent or good results were achieved for 94% of the @entity1 . A dural tear that did not violate the arachnoid membrane occurred during surgery for one @entity1 but did not require further treatment. CONCLUSION: @entity12897 can be effectively treated with a tubular retractor system in conjunction with an endoscope or @entity3178 . Use of the tubular retractor minimizes soft-tissue @entity130 , incision length, @entity190 , and disruption of ligamentous and bony structures. This may be particularly significant when @entity12897 are associated with spondylolisthesis, minimizing the risk of progressive instability and the need for fusion.
