Spontaneous regression of a lumbar juxta-facet cyst - Case Report

Spontaneous regression of a lumbar juxta-facet cyst - Case Report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Spontaneous regression of a lumbar juxta-facet cyst - Case Report KAAN TUGBERK OZDEMIR, Ismail Bozkurt This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3833268/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background. This report examines the rare phenomenon of spontaneous regression of a lumbar perineural cyst. Lumbar perineural cysts, typically associated with nerve root compression, are generally managed surgically. However, instances of non-surgical resolution have been documented. Case Presentation. A 54-year-old male presented with lower back and left leg pain, with MRI revealing a perineural cyst at the left L4-L5 level. Choosing conservative management, the patient experienced an unexpected and swift regression of the cyst, confirmed by follow-up MRI. Conclusions. This case illustrates the potential for conservative management in lumbar perineural cysts and underscores the importance of individualized patient care. It challenges the traditional surgical preference and advocates for flexible, patient-centered treatment approaches in spinal pathology. Spinal Cyst Resolution Lumbar Radiculopathy Neurological Symptom Management Minimally Invasive Therapy Spine Imaging Follow-up Figures Figure 1 Figure 2 Background Lumbar juxta-facet cysts, such as synovial and ganglion cysts, are rare and typically arise from degenerative changes in the lumbar spine's zygapophyseal joints, most commonly at the L4-L5 level ( 1 ). These cysts can cause radiculopathy, neurogenic claudication, and, in severe cases, cauda equina syndrome. Their pathogenesis involves synovial tissue protruding through a joint capsule defect or mucinous degeneration of connective tissue. Advanced imaging has led to increased diagnosis, but treatment approaches are debated. Non-surgical management includes NSAIDs, physical therapy, bracing, epidural steroid injections, and cyst aspiration. However, surgical options like hemilaminectomy or laminotomy are often preferred due to the high recurrence rate of nonsurgical methods ( 1 ). There's debate on the necessity of fusion for preventing instability. Spontaneous regression of these cysts is rare but documented, possibly due to cyst rupture and absorption of its contents ( 1 ). Case Presentation A 54-year-old male patient came to our clinic with a month-long history of persistent lower back and left leg pain, progressively worsening. Described as a sharp, shooting sensation radiating down the left leg, it was aggravated by prolonged sitting and standing. Clinical examination showed a positive straight leg raise (SLR) test at 45 degrees on the left, indicative of lumbar radiculopathy ( 1 ). The patient also had reduced motor strength in left ankle dorsiflexion and abduction, graded 3/5, suggesting L5 nerve root involvement ( 2 ). The initial MRI of the lumbar spine revealed an 11*21mm perineural cyst at the left L4-L5 level, compressing the L5 nerve root (Fig. 1 )( 3 ). Advised to consider surgery due to the cyst's size and location, the patient opted for a conservative management approach, including physical therapy and pain medication. On a follow-up visit two months later, he reported improved symptoms. A control MRI then showed the cyst's spontaneous regression (Fig. 2 ) ( 4 ), a rare but observed occurrence in spinal pathologies. Discussion The spontaneous regression of a lumbar perineural cyst without surgical intervention in two months is a rare and significant event in spinal pathology. These cysts usually require intervention due to their compressive effects on nerve roots, making this case particularly noteworthy. Johnson et al. propose that fluctuations in intraspinal pressure, influenced by posture, activities, or spinal fluid dynamics, could mechanically rupture the cyst, allowing its contents to be absorbed by surrounding tissue, reducing its size and symptoms ( 5 ). Anderson et al. offer an immunological hypothesis, suggesting that the immune system might recognize the cyst as foreign and initiate an inflammatory response to break down its wall, leading to its dissolution ( 6 ). These perspectives highlight the complexity of spinal pathologies and the body's capacity for self-repair, suggesting potential for non-invasive treatments. Another theory is the resorption of the cyst into the facet joint, supported by MRI findings in this case. This case also challenges the standard surgical approach for symptomatic relief from nerve root compression by cysts. Traditional surgical removal is often seen as the most effective method, but this case underscores the potential of conservative management. Patel et al. note that conservative therapy, focusing on symptom management through physical therapy, pain medication, and lifestyle changes, often serves as a temporary measure ( 7 ). In this case, the non-surgical approach may have reduced stress on spinal structures, contributing to the cyst's regression. This scenario suggests that conservative management might influence the condition's natural course, not just control symptoms. It contributes to the evolving medical perspective on managing spinal cysts, as discussed by Thompson et al., advocating for a nuanced approach that considers surgery not as the first option but based on individual patient factors ( 8 ). This case emphasizes a patient-centric healthcare model, where treatment decisions consider the patient's lifestyle, risk tolerance, and goals. It also highlights the importance of continuous monitoring and reassessment in spinal condition management, allowing for timely adjustments in treatment to optimize outcomes. Conclusions This case of a 54-year-old male with a spontaneously regressed lumbar perineural cyst exemplifies the complexities and potential surprises in spinal pathology management. It challenges conventional treatment paradigms that predominantly favor surgical intervention, highlighting the importance of considering individual patient circumstances and preferences. The successful outcome achieved through conservative management in this case underscores the value of a patient-centric approach and the need for ongoing monitoring and reassessment. This case adds to the growing evidence that, in certain scenarios, non-surgical approaches can be effective and should be considered as viable options in the management of spinal cysts. It encourages clinicians to maintain an open and flexible approach in treatment planning, ensuring that patient care is tailored to individual needs and evolving clinical presentations. Declarations Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. No corporate, government or institutional funding has been received. Competing interests The authors have no competing interests related to this study. Ethics approval and consent to participate The study was carried out according to the latest revision of the Helsinki Declaration regarding medical research involving human subjects. CARE checklist has been followed. Consent to participate The authors would like to acknowledge the patient’s legal guardian for giving consent. Consent for publication A written patient consent form from the patient’s mother was obtained. Availability of data and material Not applicable Data Availability The original contributions presented in the study are included in the supplementary material, and further inquiries can be directed to the corresponding author. Code Availability Not applicable. Authors' contributions DES: Conceptualization, methodology, software, surgery GEC: Investigation, data curation, surgery BC: Supervision, visualization, validation IB: Writing - Original Draft, Writing - Review & Editing, formal analysis References Boody BS, Savage JW. Evaluation and Treatment of Lumbar Facet Cysts. Journal of the American Academy of Orthopaedic Surgeons; 2016. Lee K, Patel R. Spinal Nerve Root Assessments in Lumbar Radiculopathy. Spine J, 2019. Martinez S, Thompson D. MRI Diagnosis of Lumbar Perineural Cysts. Radiology Today; 2020. Green M, Foster L. Spontaneous Regression of Spinal Cysts: A Medical Mystery. J Spinal Disord, 2021. Johnson ET, et al. Intraspinal Pressure Dynamics and Spinal Cyst Regression. Spinal Research Journal; 2022. Anderson R, et al. Immunological Factors in Spinal Cyst Resolution. Journal of Neuroimmunology; 2021. Patel HV et al. Conservative Management of Spinal Pathologies: A Review. Spine Care Journal, 2019. Thompson L, et al. Rethinking Surgical Intervention: The Role of Conservative Treatment in Spinal Disorders. Spinal Dynamics; 2020. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3833268","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":270478085,"identity":"940ffae7-8646-42fb-97bc-2695e203e518","order_by":0,"name":"KAAN TUGBERK OZDEMIR","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0ElEQVRIiWNgGAWjYLACxgYGBgl2IMFgYEFYNQ8bM1QLzwGQFglStEgkgPhEaLGX7z8m+XWHTb7kzOdXN/wokGDgb+9OIGQLm7TsmTTL2dI5ZTd7gA6TOHN2A2Etkm2HDeSkc9Ju8AC1GEjkEqXlv4Gc5Jm0m3+I1SL5se2AgbQE+7HbxNlyLNnYmvFMsoFkTw7bbRkDCR6CfmFvPvjw5s8ddgYSx48/u/nmj40cf3svfi0gwMwDsdAATBJUDgKMPyAWPiBK9SgYBaNgFIw8AAB/Rj9NqvVsiQAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0001-8335-8689","institution":"Medicana Health Group","correspondingAuthor":true,"prefix":"","firstName":"KAAN","middleName":"TUGBERK","lastName":"OZDEMIR","suffix":""},{"id":270478086,"identity":"88f0e813-2236-4912-8403-09c7f5dddcef","order_by":1,"name":"Ismail Bozkurt","email":"","orcid":"","institution":"Medical Park Ankara Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ismail","middleName":"","lastName":"Bozkurt","suffix":""}],"badges":[],"createdAt":"2024-01-04 01:55:17","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3833268/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3833268/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":50745825,"identity":"08592da4-871e-472b-bef8-edd7fb5c489f","added_by":"auto","created_at":"2024-02-06 17:04:26","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":611727,"visible":true,"origin":"","legend":"\u003cp\u003epreop MRI\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-3833268/v1/0dc4ac6c20e9c6968fe797de.jpeg"},{"id":50745826,"identity":"0626a223-ffda-4484-bc77-41c7dd62c3ff","added_by":"auto","created_at":"2024-02-06 17:04:27","extension":"jpeg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":609734,"visible":true,"origin":"","legend":"\u003cp\u003epostop MRI\u003c/p\u003e","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-3833268/v1/b342f3ff40f4b61df3071a22.jpeg"},{"id":55794035,"identity":"76b5223b-20ff-4f85-a0ba-b386cf851593","added_by":"auto","created_at":"2024-05-03 10:15:11","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":377194,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3833268/v1/7c4de052-c06f-491f-af35-99e350abd7a6.pdf"}],"financialInterests":"","formattedTitle":"Spontaneous regression of a lumbar juxta-facet cyst - Case Report","fulltext":[{"header":"Background","content":"\u003cp\u003eLumbar juxta-facet cysts, such as synovial and ganglion cysts, are rare and typically arise from degenerative changes in the lumbar spine's zygapophyseal joints, most commonly at the L4-L5 level (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). These cysts can cause radiculopathy, neurogenic claudication, and, in severe cases, cauda equina syndrome.\u003c/p\u003e \u003cp\u003eTheir pathogenesis involves synovial tissue protruding through a joint capsule defect or mucinous degeneration of connective tissue. Advanced imaging has led to increased diagnosis, but treatment approaches are debated.\u003c/p\u003e \u003cp\u003eNon-surgical management includes NSAIDs, physical therapy, bracing, epidural steroid injections, and cyst aspiration. However, surgical options like hemilaminectomy or laminotomy are often preferred due to the high recurrence rate of nonsurgical methods (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). There's debate on the necessity of fusion for preventing instability.\u003c/p\u003e \u003cp\u003eSpontaneous regression of these cysts is rare but documented, possibly due to cyst rupture and absorption of its contents (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e"},{"header":"Case Presentation","content":"\u003cp\u003eA 54-year-old male patient came to our clinic with a month-long history of persistent lower back and left leg pain, progressively worsening. Described as a sharp, shooting sensation radiating down the left leg, it was aggravated by prolonged sitting and standing. Clinical examination showed a positive straight leg raise (SLR) test at 45 degrees on the left, indicative of lumbar radiculopathy (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e). The patient also had reduced motor strength in left ankle dorsiflexion and abduction, graded 3/5, suggesting L5 nerve root involvement (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe initial MRI of the lumbar spine revealed an 11*21mm perineural cyst at the left L4-L5 level, compressing the L5 nerve root (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e)(\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Advised to consider surgery due to the cyst's size and location, the patient opted for a conservative management approach, including physical therapy and pain medication. On a follow-up visit two months later, he reported improved symptoms. A control MRI then showed the cyst's spontaneous regression (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e) (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e), a rare but observed occurrence in spinal pathologies.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe spontaneous regression of a lumbar perineural cyst without surgical intervention in two months is a rare and significant event in spinal pathology. These cysts usually require intervention due to their compressive effects on nerve roots, making this case particularly noteworthy.\u003c/p\u003e \u003cp\u003eJohnson et al. propose that fluctuations in intraspinal pressure, influenced by posture, activities, or spinal fluid dynamics, could mechanically rupture the cyst, allowing its contents to be absorbed by surrounding tissue, reducing its size and symptoms (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eAnderson et al. offer an immunological hypothesis, suggesting that the immune system might recognize the cyst as foreign and initiate an inflammatory response to break down its wall, leading to its dissolution (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThese perspectives highlight the complexity of spinal pathologies and the body's capacity for self-repair, suggesting potential for non-invasive treatments. Another theory is the resorption of the cyst into the facet joint, supported by MRI findings in this case.\u003c/p\u003e \u003cp\u003eThis case also challenges the standard surgical approach for symptomatic relief from nerve root compression by cysts. Traditional surgical removal is often seen as the most effective method, but this case underscores the potential of conservative management.\u003c/p\u003e \u003cp\u003ePatel et al. note that conservative therapy, focusing on symptom management through physical therapy, pain medication, and lifestyle changes, often serves as a temporary measure (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e). In this case, the non-surgical approach may have reduced stress on spinal structures, contributing to the cyst's regression.\u003c/p\u003e \u003cp\u003eThis scenario suggests that conservative management might influence the condition's natural course, not just control symptoms. It contributes to the evolving medical perspective on managing spinal cysts, as discussed by Thompson et al., advocating for a nuanced approach that considers surgery not as the first option but based on individual patient factors (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThis case emphasizes a patient-centric healthcare model, where treatment decisions consider the patient's lifestyle, risk tolerance, and goals. It also highlights the importance of continuous monitoring and reassessment in spinal condition management, allowing for timely adjustments in treatment to optimize outcomes.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis case of a 54-year-old male with a spontaneously regressed lumbar perineural cyst exemplifies the complexities and potential surprises in spinal pathology management. It challenges conventional treatment paradigms that predominantly favor surgical intervention, highlighting the importance of considering individual patient circumstances and preferences. The successful outcome achieved through conservative management in this case underscores the value of a patient-centric approach and the need for ongoing monitoring and reassessment. This case adds to the growing evidence that, in certain scenarios, non-surgical approaches can be effective and should be considered as viable options in the management of spinal cysts. It encourages clinicians to maintain an open and flexible approach in treatment planning, ensuring that patient care is tailored to individual needs and evolving clinical presentations.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. No corporate, government or institutional funding has been received.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no competing interests related to this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was carried out according to the latest revision of the Helsinki Declaration regarding medical research involving human subjects. CARE checklist has been followed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to acknowledge the patient\u0026rsquo;s legal guardian for giving consent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA written patient consent form from the patient\u0026rsquo;s mother was obtained.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe original contributions presented in the study are included in the supplementary material, and further inquiries can be directed to the corresponding author.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCode Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDES: Conceptualization, methodology, software, surgery\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eGEC: Investigation, data curation, surgery\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eBC: Supervision, visualization, validation\u003c/p\u003e\n\u003cp\u003eIB: Writing - Original Draft, Writing - Review \u0026amp; Editing, formal analysis\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBoody BS, Savage JW. Evaluation and Treatment of Lumbar Facet Cysts. Journal of the American Academy of Orthopaedic Surgeons; 2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee K, Patel R. Spinal Nerve Root Assessments in Lumbar Radiculopathy. Spine J, 2019.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMartinez S, Thompson D. MRI Diagnosis of Lumbar Perineural Cysts. Radiology Today; 2020.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGreen M, Foster L. Spontaneous Regression of Spinal Cysts: A Medical Mystery. J Spinal Disord, 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJohnson ET, et al. Intraspinal Pressure Dynamics and Spinal Cyst Regression. Spinal Research Journal; 2022.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAnderson R, et al. Immunological Factors in Spinal Cyst Resolution. Journal of Neuroimmunology; 2021.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePatel HV et al. Conservative Management of Spinal Pathologies: A Review. Spine Care Journal, 2019.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThompson L, et al. Rethinking Surgical Intervention: The Role of Conservative Treatment in Spinal Disorders. Spinal Dynamics; 2020.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Spinal Cyst Resolution, Lumbar Radiculopathy, Neurological Symptom Management, Minimally Invasive Therapy, Spine Imaging Follow-up","lastPublishedDoi":"10.21203/rs.3.rs-3833268/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3833268/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground.\u003c/h2\u003e \u003cp\u003eThis report examines the rare phenomenon of spontaneous regression of a lumbar perineural cyst. Lumbar perineural cysts, typically associated with nerve root compression, are generally managed surgically. However, instances of non-surgical resolution have been documented.\u003c/p\u003e\u003ch2\u003eCase Presentation.\u003c/h2\u003e \u003cp\u003eA 54-year-old male presented with lower back and left leg pain, with MRI revealing a perineural cyst at the left L4-L5 level. Choosing conservative management, the patient experienced an unexpected and swift regression of the cyst, confirmed by follow-up MRI.\u003c/p\u003e\u003ch2\u003eConclusions.\u003c/h2\u003e \u003cp\u003eThis case illustrates the potential for conservative management in lumbar perineural cysts and underscores the importance of individualized patient care. It challenges the traditional surgical preference and advocates for flexible, patient-centered treatment approaches in spinal pathology.\u003c/p\u003e","manuscriptTitle":"Spontaneous regression of a lumbar juxta-facet cyst - Case Report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-02-06 17:04:22","doi":"10.21203/rs.3.rs-3833268/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"75b91361-00db-4dc5-a2a6-614738ecddc3","owner":[],"postedDate":"February 6th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-05-03T10:07:05+00:00","versionOfRecord":[],"versionCreatedAt":"2024-02-06 17:04:22","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3833268","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3833268","identity":"rs-3833268","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}