Learning About Facet Cyst Removal

A facet cyst is a small sac located in a facet joint. The sac may be filled with liquid, mucus, or blood. Your doctor may also call it a synovial facet cyst.

Facet joints are small joints located between each bone (vertebra) in your spine. These joints connect vertebrae that are next to each other. The facet joints hold your back together when you move and twist, and they keep you from moving your back too much.

A facet cyst may happen when a facet joint wears out or is unstable. As the cyst grows, it can press against the spinal canal, causing the canal to become narrower (lumbar spinal stenosis). This can lead to pain in the lower back and on one side of the buttocks and down one leg when walking.

Your doctor may recommend having the cyst removed if it is large, if the pain makes it hard to move, and if medicine and physical therapy aren’t helping.

All surgery has risks. Complications may depend on what other medical problems you have. Risks may include:

• Nerve or spinal cord injury.
• Infection.
• Problems with anesthesia.
• A possibility that the problem may come back.
• A tear in the membrane (dura) that covers the spinal cord. This may cause cerebrospinal fluid (CSF) to leak.

Your surgeon will get images of where the cyst is located. They may include X-rays, CT scans, and an MRI. The images help guide your surgeon to the exact spot where the cyst is.

The surgeon makes a small cut near the site of the cyst. A small tube is placed in the incision. A camera, a light, and small tools are passed through the tube. The cyst may be grabbed and gently pulled and then cut away from the dura. In some cases, the cyst may be hard to take out because it's stuck to the dura. The surgeon may just remove the contents of the cyst and leave the rest of it there. In this case, it's still an effective treatment.

When the surgery is done, the surgeon closes the incision with stitches or glue. A bandage is put on the wound.

You'll be asleep for the surgery. It usually takes from 90 minutes to 2 hours.

After surgery, you’ll be moved to a recovery room, also called the post-anesthesia care unit (PACU). You’ll stay there until you’re fully awake and stable. You will likely go home the same day.

You'll likely have some discomfort after surgery. You may receive pain medicine orally or through an intravenous (I.V.) line in a vein.

You’ll likely get on your feet within 24 hours after surgery. A nurse or physical therapist will teach you how to brace yourself, turn, and get out of bed safely.

Soon after surgery, you’ll be encouraged to get up and walk. This helps your blood circulation and prevents constipation. It also keeps fluid from building up in your lungs. To help you move, you may be given a brace to support your spine. You may also see a physical therapist, who will teach you ways to protect your spine while lying down, sitting, standing, or moving.