Study Of the Surgical Treatment of Synovial Cysts of The Spine: A Systematic Review with Meta-Analysis

Abstract

Objective: The aim of this study is to evaluate the effectiveness of minimally invasive surgical treatment for patients with synovial cysts of the lumbar spine, comparing the results between the interlaminar and transforaminal routes, according to the post-operative results. Methodology: Systematic review with meta-analysis, registered under the prestigious ID CRD42024557771. The research questions were defined using the PICOS model in accordance with the PRISMA guidelines. Results: 208 patients were included, of whom 25 did not continue and were excluded from the study, and 183 were analyzed. The patients underwent surgery via the interlaminar and transforaminal routes. In the evaluation of MacNab's criteria, most of the patients had excellent and good results; those who had poor results had some degree of spondylolisthesis and were re-approved, with improvement in their pain. Conclusion: Synovial cysts can be effectively treated with a tubular retractor system in conjunction with an endoscope or microscope. The use of a retractor minimizes soft tissue trauma, incision length and blood loss. In addition, the rupture of ligament and bone structures is minimized with a unilateral approach, which is important in those patients where the synovial cyst is associated with spondylolisthesis, reducing the risk of progressive instability and the need for spinal fusion.