Spontaneous Resolution of Lumbar Facet Joint Cyst.

Abstract

Juxtafacet cysts (JFCs) are uncommon spinal lesions that can cause neural compression and are typically managed surgically. Rarely, JFCs can spontaneously resolve. We present the case of a spontaneously resolving right L4/5 JFC in an otherwise fit and well 60-year-old female. She presented with progressive chronic lower back pain and intermittent sciatica. She had no neurologic deficit. The patient was keen to avoid surgical intervention. After 19 months her symptoms had significantly improved, and repeat magnetic resonance image demonstrated complete resolution of the lesion. While surgery to remove a JFC ± spinal stabilization remains the mainstay and definitive treatment for symptomatic JFCs, patients without neurologic deficit may be safely managed conservatively pending possible spontaneous resolution. Spontaneous resolution may reflect the natural history of the condition.