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A 50 year old lady comes in with four months of left back, buttock, and hip pain. The pain travels down her lateral buttock and thigh to her knee. She has seen a chiropractor, tried physical therapy, and used a topical anti-inflammatory all without significant relief.

  • Preoperative AP (anteroposterior) X-ray shows mild degenerative changes.
  • Preoperative lateral X-ray shows mild degenerative changes. Grade 1 spondylolisthesis at L3-4
  • Axial T2-weighted MRI shows a left-sided synovial cyst at L3-4 impinging on the traversing nerve root
  • Sagittal T2-weighted MRI (line indicates location of axial L3-4 MRI image)

The patient elected to proceed with a minimally invasive left L3-4 decompression with excision of synovial cyst. The entire procedure was done through a less than a one-inch incision. The patient went home the same day with a band-aid for a dressing. Just a couple days later the patient was back at work pain-free!