Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 16, 2022; 10(32): 11936-11941
Published online Nov 16, 2022. doi: 10.12998/wjcc.v10.i32.11936
Management of symptomatic cervical facet cyst with cervical interlaminar epidural block: A case report
Seong Min Hwang, Min Kyu Lee, Saeyoung Kim
Seong Min Hwang, Min Kyu Lee, Saeyoung Kim, Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, Daegu 41944, South Korea
Author contributions: Hwang SM contributed to manuscript writing and editing; Lee MK contributed to data collection; Kim S contributed to conceptualization and supervision; all authors have read and approved the final manuscript.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Saeyoung Kim, MD, PhD, Professor, Department of Anesthesiology and Pain Medicine, School of Medicine, Kyungpook National University, 130 Dongdeok-ro, Jung-gu, Daegu 41944, South Korea. saeyoungkim7@gmail.com
Received: June 29, 2022
Peer-review started: June 29, 2022
First decision: September 5, 2022
Revised: September 7, 2022
Accepted: October 11, 2022
Article in press: October 11, 2022
Published online: November 16, 2022
Processing time: 132 Days and 2.6 Hours
Abstract
BACKGROUND

Symptomatic cervical facet cysts are relatively rare compared to those in the lumbar region. These cysts are usually located in the 7th cervical and 1st thoracic vertebral (C7/T1) area, and surgical excision is performed in most cases. However, facet cysts are associated with degenerative conditions, and elderly patients are often ineligible for surgical procedures. Cervical interlaminar epidural block has been used in patients with cervical radiating symptoms and achieved good results. Therefore, cervical interlaminar epidural block may be the first-choice treatment for symptomatic cervical facet cysts.

CASE SUMMARY

A 70-year-old man complained of a tingling sensation in the left hand, focused on the 4th and 5th fingers, for 1 year, and posterior neck pain for over 5 mo. The patient’s numeric rating scale (NRS) score was 5/10. The patient was diagnosed with symptomatic cervical facet cyst at the left C7/T1 facet joint. Fluoroscopy-guided cervical interlaminar epidural block at the C7/T1 level with 20 mg triamcinolone and 5 mL of 0.5% lidocaine was administered. The patient's symptoms improved immediately after the block, with an NRS score of 3 points. After 3 mo, his left posterior neck pain and tingling along the left 8th cervical dermatome were relieved, with an NRS score of 2.

CONCLUSION

A cervical interlaminar epidural block is a good alternative for managing symptomatic cervical facet cysts.

Keywords: Cervical vertebrae; Cysts; Epidural; Injections; Neck pain; Therapeutics; Zygapophyseal joint; Case report

Core Tip: Intraspinal facet cysts are usually asymptomatic and incidentally identified. However, they could be symptomatic and interfere with the patient’s quality of life. Symptomatic cervical facet cysts are relatively rare compared to those in the lumbar region. Guidelines for the management of cervical facet cysts have not been well established. Several patients reported in the existing literature underwent surgery for symptomatic cervical facet cysts, but there are situations where surgery may not be possible, such as an underlying disorder or refusal of the patient. In such cases, a cervical interlaminar epidural block can be a good alternative.