Rapid spontaneous resolution of lumbar ganglion cysts: A case report

Table 1 Macnab[3] criteria used for measuring outcome

Grade	Criteria
Excellent	No pain; no restriction of activity
Good	Occasional back or leg pain of sufficient severity to interfere with the patient’s ability to do his normal work
Fair	Improved functional capacity, but handicapped by intermittent pain of sufficient severity to curtail or modify work or leisure activities
Poor	No improvement or insufficient improvement to enable increase in activities; further operative intervention required

Table 2 Regression of lumbar ganglion cyst: Our case and 25 from literature

	Author/Yr	Age	Sex	Level/ Side	Classification1	Imaging	Instability	Symptoms	Duration	Deficit	Treat-ment	Imag-ing control/Time	Instability control	Control	Out-come2
1	Mercader et al[2], 1985	65	F	L4-L5/ right	Med-Int	CT	SPL	Rad	8 mo	\	Rest-NSAID-KT-brace	CT reduction/3 mo	SPL	3 mo	Good
2	Coulier et al[4], 1998	47	F	L4-L5/bilat	Med/ Med	CT	NR	LBP	NR	\	Brace	CT/20 mo: left resolution, right reduced	NR	20 mo	Excel-lent
3	Maezawa et al[5], 2000	15	M	L4-L5/left	Med	MRI	NR	LBP + Rad	2 mo	\	Brace	MRI resolution/3 mo	NR	3 mo	Excel-lent
4	Houten et al[6], 2003	64	M	L4-L5/ right	NA	MRI	NR	LBP + Rad	7 mo	\	Conservative (na)	MRI resolution/1 mo (na images)	NR	1 mo	Good
5		57	F	L4-L5/left	NA	MRI	NR	Rad	5 mo	\	NSAID-gabap-entin	MRI resolution/8 mo (na images)	NR	8 mo	Good
6		58	F	L4-L5/left	Med-Ext	MRI	NR	LBP + Rad	18 mo	\	Conservative (na)	MRI resolution/4 mo	NR	4 mo	Good
7	Swartz et al[7], 2003	58	F	L5-S1/ right	Med-Ext	MRI	SPL	Rad	1 mo	\	Rest-NSAID-KT-brace	MRI resolution/18 mo	SPL	12 mo	Good
8	Cox[8], 2005	71	M	L3-L4/ right	NA	MRI	NR	Rad	6 mo	\	Rest-NSAID- chiropractic	MRI reduction/9 mo	NR	9 mo	Good
9		59	F	L4-L5/left	Med-Ext	MRI	IFFa	Rad	NR	\	Rest-NSAID-chirop-ractic	Not performed	NR	2 mo	Excellent
10	Ewald et al[9], 2005	65	F	L4-L5/ right	Med-Ext	MRI	SPL	Rad	5 mo	\	Rest-NSAID-KT	MRI reduction/3 mo	SPL	3 mo	Good
11	Illerhaus et al[10], 2005	50	M	L4-L5/ right	Med-Int	MRI	IFFa	LBP + Rad	12 mo	\	NSAID-KT	MRI resolution/7 mo	IFFa	7 mo	Good
12	Beukelaar et al[11], 2010	59	M	L4-L5/ right	Med	MRI	IFFa	LBP + Rad	2 mo	L5 S	Conservative (na)	MRI reduction/3 mo	IFFb	3 mo	Excellent
13	Bashir et al[12], 2012	47	M	L4-L5/ right	NA	MRI	NR	Rad	6 mo	\	Rest-NSAID-KT	Not performed	NR	24 mo	Excellent
14		58	M	L4-L5/left	Med	MRI	IFFa	Rad	3 mo	\	Rest-NSAID-KT	MRI resolution/2 mo (na images)	NR	2 mo	Excellent
15		41	M	L5-S1/ right	NA	MRI	NR	Rad	12 mo	\	Rest-NSAID-KT	Not performed	NR	24 mo	Excellent
16	Barazi et al[13], 2012	48	F	L4-L5/ right	NA	MRI	NR	Rad	NR	\	Conservative (na)	MRI resolution/8 mo (na images)	NR	8 mo	Good
17	Cox et al[14], 2012	75	M	L3-L4/left	Med-Int	MRI	NR	Rad	36 mo	\	Chiropractic	Not performed	NR	2 mo	Good
18	Tepe et al[15], 2012	64	M	L5-S1/left	Ext	MRI	SPL	Rad	2 mo	L5 S	Conservative (na)	MRI reduction/1 yr, resolu-tion/4 yr	SPL	12 mo	Good
19	Mattei et al[16], 2012	56	M	L5-S1/ right	Med	MRI	IFFa	Rad	NR	S1 S	NSAID-KT	MRI resolution/13 mo	IFFa	1 mo	Excellent
20	Pulhornet al[17], 2012	72	M	L4-L5/ right	Med-Ext	MRI	IFFa	LBP	NR	\	Conservative (na)	MRI resolution/18 mo	IFFa	18 mo	Excellent
21	Ngo et al[18], 2013	58	F	L4-L5/ right	Med-Ext	MRI	NR	LBP + Rad	5 d	\	SAID-chiropractic	Not performed	NR	3 mo	Excellent
22	Kim et al[19], 2015	58	M	L3-L4/left	Med-Ext	MRI	SPL	LBP + Rad	4 mo	\	Conservative (na)	MRI resolution/4 yr	SPL	1 mo	Excellent
23	Delen et al[20], 2015	63	M	L5-S1/left	Med	MRI	IFFa	LBP + Rad	1 mo	S1 S	NSAID-gabapentin	MRI resolution/1 mo	↑IFF	1 mo	Excellent
24	Sinha et al[21], 2016	66	M	L5-S1/left	Med-Int	MRI	NR	LBP + Rad	12 mo	\	Conservative (na)	MRI resolution/12 mo	NR	12 mo	Good
25	Ucler et al[22], 2017	36	F	L4-L5/ right	Med-Ext	MRI	IFFa	LBP + Rad	10 d	\	Rest	MRI resolution/2 d	IFFa	2 d	Excellent
26	Our case	51	M	L4-L5/ right	Med-Ext	MRI	IFFa	LBP + Rad	10 d	\	Rest-NSAID-SAID-brace	MRI resolution/1 mo	IFFb	1 mo	Excellent

¹Domenicucci et al[1];

²Macnab[3]; SPL: Spondylolisthesis; IFF: Interfacet fluid; LBP: Low back pain; Rad: Radiculopathy; S: Sensory deficits; NSAID: Nonsteroidal anti-inflammatory drug; SAID: Steroidal anti-inflammatory drug; KT: Kinesiotherapy; NR: Not reported; NA: Not available data; med: Medial; int: Internal; ext: External; MRI: Magnetic resonance; CT: Computed tomography;

^aIncrease;

^bDecrease.