The main objective was to describe the different types and characteristics of lumbar spine extradural cysts and their optimal treatment options with a focus on endoscopic technique. We searched Pubmed, EMBASE, Medline, and Google Scholar for articles published between 1967 and 2020 using the keywords “Spinal Cyst,” “Extradural Cyst,” and “Lumbar Cyst.” The various anatomical and histological types of the extradural cysts with their presentations, etiologies, imaging, and optimal treatment with a focus on endoscopic techniques were reviewed from the articles. Lumbar spinal cysts are relatively rare pathologies that might cause radicular symptoms similar to lumbar disc herniation. Spinal extradural cysts are classified either histologically based on the cyst lining tissues (synovial cysts or non-synovial, ganglion cysts) or anatomically based on the structure of origin (epidural cysts, ligamentum flavum cysts, discal cysts, post-discectomy pseudocysts, posterior longitudinal ligament cysts, facet cysts). Surgical excision is the recommended treatment of symptomatic cysts with endoscopic techniques being a viable option. Extradural lumbar cysts can be identified based on their histological structure or depending on their structure of origin. Regardless of their classification, they could all give similar clinical findings, and the optimal treatment would be surgical excision with endoscopic technique being a viable option with a satisfactory outcome.

Background: Percutaneous endoscopic lumbar discectomy (PELD) is a minimally invasive surgical technique for the treatment of lumbar disc herniation. Despite its growing popularity, limited research has explored the influence of patient characteristics and the choice of technique on post-operative outcomes and patient satisfaction. Objective: To investigate the impact of patient characteristics and surgical technique (interlaminar vs. transforaminal) on the surgical outcomes and patient satisfaction following PELD. Methods: A retrospective analysis was conducted on 177 patients who underwent PELD (53.1% males, age = 46.11 ± 14.2 years), including 147 patients with the interlaminar approach and 30 with the transforaminal approach. Demographic data, pre-operative clinical features, surgical technique, intra-operative and post-operative complications and complaints, patient-reported outcomes (disability, quality of life, satisfaction), and revision surgery rates were documented and analyzed. The mean follow-up duration was 5.55 years ± 2.73 years. Results: No significant differences were observed in demographics, pre-operative status, or post-operative complaints and complication rates between two surgical techniques, except that transforaminal technique showed a higher incidence for dural tear and persistent muscle weakness (p = 0.028 and p = 0.046, respectively). Both techniques led to excellent patient-reported outcomes with no significant differences. Total patient satisfaction with PELD was 93.8%, which correlated positively with the absence of complications and complaints and negatively with persistent back pain, recurrent herniation and revision surgery. Conclusions: Interlaminar and transforaminal PELD are both effective and safe minimally invasive surgical techniques for the treatment of lumbar disc herniation with a high patient satisfaction rate. Further prospective studies are warranted to confirm these findings.

Introduction: Synovial cysts of the lumbar spine are rare pathologies that can cause significant nerve root compression. Traditional surgical treatments often involve open laminectomy with medial facetectomy, which often lead to instability requiring fusion and instrumentation. We present a case of a giant synovial cyst at the L4–L5 level successfully treated using full endoscopic inter-laminar approach. Case Report: A 69-year-old male presented with chronic low back pain and left leg radiculopathy. Imaging revealed a giant synovial cyst at L4–L5 level causing severe significant nerve root compression. The patient underwent a full endoscopic inter-laminar approach for total excision of the cyst. Postoperatively, the patient’s symptoms resolved, without cyst recurrence or instability at 1 year. Conclusion: Endoscopic total excision of giant synovial cysts is a surgical option that can effectively address symptoms while minimizing the risk of segmental instability. This case demonstrates the feasibility and benefits of this minimally invasive approach. Keywords: Synovial cyst, spine, endoscopy, fusion, instability.

Aneurysmal bone cyst is a benign locally aggressive bone tumor that was first described in 1947. It affects most frequently long bones of the skeleton; its presence at the level of the metatarsal bone is very rare, which was firstly reported in 1957. We present herein a rare case of aneurysmal bone cyst in a 15-year-old female patient treated with excisional biopsy, curettage and bone grafting with favorable outcomes.

We present in our article a case report of a patient who presented to us with bilateral foot drop secondary to L4-5 traumatic spondylolisthesis that occurred 3 months prior to her presentation to our hospital. She was treated surgically in two stages, the first stage included a wide laminectomy with bilateral facetectomies, followed by a progressive reduction of the listhesis and posterior pedicle screw fixation. The second stage followed which include anterior column support using a cage at L4-5 level. The patient showed remarkable recovery of her neurological status that started at the second postoperative day and had almost complete recovery after around 6 weeks. In case of traumatic spondylolisthesis with neurological compromise, surgical decompression and stabilization should be considered, even in late presentation, because neurological recovery is possible.