Described first by Kao et al., ¹⁾. these cysts are adjacent to a spinal facet joint or arising from the ligamentum flavum.

Synovial cyst

Ganglion cysts

Distinction of these types is difficult without histology and is clinically unimportant ²⁾.

Cervical juxtafacet cyst

Lumbar juxtafacet cyst

Hemorrhage from a ganglion cyst is rare and the rate of hemorrhagic incidence is less than 10%.

Although the suspected causal factors such as anticoagulation therapy, trauma, and the presence of a vascular anomaly has been proposed, the etiology of the hemorrhage from the juxtafacet cysts is still unclear.

The similar conditions differently called a ligamentum flavum hematoma, juxtafacet cyst hematoma, hemorrhagic synovial cyst and facet apoplexy have been reported ³⁾.

A 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.

Complete follow-up is available in 74 patients. Mean follow-up in all 74 patients was 69±34months (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.

In 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 instability⁴⁾.