Journal of Back and Musculoskeletal Rehabilitation - Volume 3, issue 3
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Journal of Back and Musculoskeletal Rehabilitation is a journal whose main focus is to present relevant information about the interdisciplinary approach to musculoskeletal rehabilitation for clinicians who treat patients with back and musculoskeletal pain complaints. It will provide readers with both 1) a general fund of knowledge on the assessment and management of specific problems and 2) new information considered to be state-of-the-art in the field. The intended audience is multidisciplinary as well as multi-specialty.
In each issue clinicians can find information which they can use in their patient setting the very next day. Manuscripts are provided from a range of health care providers including those in physical medicine, orthopedic surgery, rheumatology, neurosurgery, physical therapy, radiology, osteopathy, chiropractic and nursing on topics ranging from chronic pain to sports medicine. Diagnostic decision trees and treatment algorithms are encouraged in each manuscript. Controversial topics are discussed in commentaries and rebuttals. Associated areas such as medical-legal, worker's compensation and practice guidelines are included.
The journal publishes original research papers, review articles, programme descriptions and cast studies. Letters to the editors, commentaries, and editorials are also welcomed. Manuscripts are peer reviewed. Constructive critiques are given to each author. Suggestions for thematic issues and proposed manuscripts are welcomed.
Abstract: A case of persistent low back pain occurring in association with facet joint synovial cysts is presented. A history of low back pain and negative plain radiographs illustrate the nonspecific nature of the problem these cysts cause. Magnetic resonance imaging (MRI) clearly demonstrates the presence of lumbar facet joint cysts. Our patient underwent a L5-S1 laminectomy prior to presenting with a new episode of low back pain. Workup, including computed tomography (CT) scan and MRI, confirmed the presence of bilateral synovial cysts at the L4-5 level. Our patient exhibited a partial clinical improvement after surgical excision of bilateral facet joint…cysts. Intraspinal synovial or ganglion cysts of the facet joints are rarely diagnosed. They originate from the synovium of the facet articulation. They can be a source of low back pain1 and present an important diagnostic and therapeutic challenge. Their presence can be easily overlooked using standard radiological techniques2 which may only demonstrate nonspecific degenerative changes such as disc space narrowing and osteophytes. If the patient undergoes surgery and the cyst is not identified preoperatively, the patient may be left with persistent back pain. Computed tomography scan and myelogram have been shown to demonstrate cystic lesions with calcified walls typical of facet joint cysts.3,4 In our case MRI definitively identified what was suspected on the CT scan. It is proposed that MRI is also a valuable, if not better imaging technique of the identification of these cysts.
Keywords: Low back pain, facet cysts, magnetic resonance imaging (MRI)