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Old 08-13-2004, 07:01 AM   #1
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Question Neurosurgeon or Orthopedist for Facet Joint Cyst?

Does anyone know which type of doctor would be best to see for a facet joint cyst (L4-L5)(a neurosurgeon or orthopedist)?

Also, has anyone had any luck with getting the facet joint cyst aspirated instead of the surgery?

 
Old 08-13-2004, 03:22 PM   #2
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Re: Neurosurgeon or Orthopedist for Facet Joint Cyst?

Neurologist work with nerves and orthos work with bones and joints. I went to Neurologist for my cysts. Did they tell you that you had them or did they show you on an MRI? They are pretty rare so I would look for someone who has worked with them before.

 
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Old 08-14-2004, 07:50 AM   #3
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Re: Neurosurgeon or Orthopedist for Facet Joint Cyst?

Sara--Part of your question recently came up for a friend of mine. We found a recent study (April '04) that suggested good results with aspiration. There were about 50 patients in the study. The results were better for those with larger cysts as I recall.

Standingman

 
Old 08-14-2004, 02:15 PM   #4
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Re: Neurosurgeon or Orthopedist for Facet Joint Cyst?

Injured Betty - The Neurosurgeon "suspected" a facet joint cyst when he looked at the MRI. The radiologist thought maybe it was a "Free fragment" and made no mention of a facet joint cyst. The Neurosurgeon said if he did a minimally invasive discectomy, then he would know what it was and which procedure to do. I would like to ask about aspiration and am not sure who to see (another neurosurgeon or an orthopedist). What happened with your cysts?
Thanks for all of your input.

 
Old 08-14-2004, 02:17 PM   #5
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Re: Neurosurgeon or Orthopedist for Facet Joint Cyst?

Standingman - Who do you think I should make a consultation with regarding aspsiration (Neurosurgeon or Orthopedist)?

 
Old 08-14-2004, 06:34 PM   #6
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Re: Neurosurgeon or Orthopedist for Facet Joint Cyst?

As these are really rare, I would question any doctor who want to do surgery to just take a look. Cutting on someone is never okay unless there is substantial proof that this is the last resort.

Have you done a net surfing trip to read about these? If the MRI didn't show specific cysts then I would seek another opinion as from what I have seen on the net pictures, they are obvious with an MRI.

As injured betty stated, orthos for bones and joints, Neurosurgeons for nerves. I would go with a Neurosurgeon for the cysts.

 
Old 08-14-2004, 06:37 PM   #7
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Re: Neurosurgeon or Orthopedist for Facet Joint Cyst?

are a well documented but rare pathology

 
Old 08-15-2004, 10:20 AM   #8
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Talking Re: Neurosurgeon or Orthopedist for Facet Joint Cyst?

Dear Moonlight,
Thank you for the information. I did do some net surfing regarding this. I have a consultation coming up with another neursurgeon later this month. I am anxious to hear his diagnosis. Thank you, again, for the help. This board really helps.

Last edited by Sara5678; 08-15-2004 at 10:22 AM.

 
Old 08-15-2004, 05:03 PM   #9
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Re: Neurosurgeon or Orthopedist for Facet Joint Cyst?

Sara,
It felt like I had tennis balls in my back. I could feel the cysts. I was in so much pain that I was at the point where I was ready to have SI injections even though I knew the damage that they cause. I refused to take pain meds as I am an addict. With time, the cysts went away. No one knows why. We know why they formed, as a result of an injury. I was told that they needed to come out. I researched them immediately after leaving the doctor's office. The surgery looked scary to me. At the time I had not seen the information that they could asperate them. Since they were rare, I didn't want just anyone working on them. I waited it out.

It got so bad that I went back in. I was willing to do the shots. I even picked up the script for pain meds. The doctor had stuck his knuckle in my back, right where they were and took me to my knees.

I waited to see if I could ride it out. I did. I have felt back there and they seem to have gone away. One of the doctors had told me that they could break them up. I guess that this doctor did this with his knuckle. I didn't end up with the shots or taking the narcotics.

I know that there is the possibilty that they can grow back. Even if you have them surgically removed, it is like getting a bone spur, they grow back. I am just keeping my fingers crossed.

So far, I am pain free and have been for a couple of months now.

 
Old 08-15-2004, 07:05 PM   #10
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Re: Neurosurgeon or Orthopedist for Facet Joint Cyst?

Injured Betty - Regarding the pain that you had from them, was it all the time or stronger in the morning than in the evening? Where was your pain located?
It is wonderful that you have relief. How long did you have them?

 
Old 08-15-2004, 09:20 PM   #11
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Re: Neurosurgeon or Orthopedist for Facet Joint Cyst?

Didn't really notice them until about six months after my injury that occured back in june '03. I guess that they were secondary to my injury.

When I got up in the mornings, after using the "pillow between the legs all night" I was find. I could go about my day. As the day went on, they became more swollen (?) The pain was worse at night.

The worst pain was when the doctor found them with his hand when lifting my leg to test my ligaments. Then the next worst pain was when the other doctor stuck his knuckle into my SI.

The swelling went down when I used Bextra. I am not sure if it was related to it or if it was a coincidence. I stopped the Bextra once I realized that arthritis, which I have in L4, is forever and I didn't want to keep taking it for live.

The cysts disappeared as mysteriously as they appeared. I am just hoping that they don't return. There is not much info out there in regards to them.

 
Old 08-16-2004, 05:56 AM   #12
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Question Re: Neurosurgeon or Orthopedist for Facet Joint Cyst?

Injured Bety-
When the doctor found them with his hand, were they close to the skin on the outside of the SI? Were they ever diagnosed from an MRI or x-ray? Did you have pain in your leg?

 
Old 08-16-2004, 09:25 AM   #13
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Re: Neurosurgeon or Orthopedist for Facet Joint Cyst?

No pain in the leg, so not impinging on a nerve.

Not close to the skin.

You could feel them when you pressed in the SI area. Like big knots of fluid that moved when you pushed on them. VERY painful.

They did a second MRI, once they realized that they were there. The Neurologist said that he saw them on the first MRI. I was sent for a second MRI. They didn't indicate to the person taking the MRI that it was to be of the SI, and not just the lower spine, and they didn't get the correct pics. So, I was scheduled for a third MRI. I was not about to pay for another one. MRI's was very area specific. We went with the findings of the first MRI.

If I were to have a third one now, I am not sure if the cysts would still be there as I don't feel them anymore after he mashed them and broke them up.

I had the same things with my breasts when I first got implants. They hardened. I went in and the doctor broke up them up as they had capsulated. No more problems with them after that. So, I am wondering if the doctor managed to break up the cysts in my back or if they just are not swollen and filled with liquid right now. My biggest fear was that they were abnormal cell growth.

 
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