Fig. 2. Three staged minimally invasive interventional procedures for the facet joint cysts. (A) The first step is placement of a needle into the targeted facet joint and injection of the contrast medium for bursting the facet joint cyst. However, half of ruptured cysts can grow again and elicit radiculopathy within 3 years. (B) Enucleation of the root of the cyst with using a bipolar radiofrequency after injection of mixture of contrast medium and indigo carmine into the targeted facet joint is the second step after bursting. However, half of the cases of cystic enucleation have recurrence. (C) Endoscopic removal of involved superior articular process after recurrence of cystic enucleation is the third step before open surgery with fusion for preventing recurrence of facet joint cyst. The hypertrophied superior articular process which compresses dorsal root ganglion is removed. Adapted from the article of Kim et al. (Pain Physician 2019; 22: E451-6) [
39].
