Original articleMicrosurgical resection of juxtafacet cysts without concomitant fusion-Long-term follow-up of 74 patients

•In most patients a solitary resection of a juxtafacet cyst is sufficient.•Only patients with distinct criteria of instability should receive concomitant fusion.•The risk of instability after solitary cyst resection is approximately 5%.•Patients should be sufficiently informed about clinical symptoms of instability.•Patients should be regularly reevaluated after juxtafacet cyst resection.

ObjectWe report on our experience with treating juxtafacet cysts focusing on clinical outcome, rate of recurrence and secondary surgery, especially fusion.MethodsThis retrospective study evaluates patients who underwent surgical resection of juxtafacet cysts without concomitant fusion from 2002 to 2013 with a minimum follow-up of one year.ResultsComplete follow-up is available in 74 patients. Mean follow-up in all 74 patients was 69 ± 34 months (range, 14-140 months). Mean ODI was 14.9%. 68 patients (91.9%) were pleased with the results and would undergo surgery again. Three patients (4.1%) underwent secondary resection because of cyst recurrence at the same site. Four patients (5.4%) needed secondary fusion.ConclusionsIn patients without evident clinical and radiological criteria of instability we regard surgical resection of juxtafacet cysts without concomitant fusion as adequate primary treatment due to good outcome and low incidence of secondary symptomatic instability.