62268 Percutaneous aspiration, spinal cord cyst or syrinx

Name of the Procedure:

Percutaneous Aspiration, Spinal Cord Cyst or Syrinx
Common name(s): Spinal cyst aspiration, Syrinx drainage
Technical/Medical term: Percutaneous Aspiration of a Spinal Cord Cyst or Syrinx

Summary

Percutaneous aspiration of a spinal cord cyst or syrinx is a minimally invasive procedure that involves using a needle to remove fluid from a cyst or cavity within the spinal cord. This is done to relieve symptoms and improve function.

Purpose

This procedure addresses conditions like spinal cord cysts or syringomyelia (syrinx). The goal is to reduce pressure and fluid accumulation within the spinal cord, thereby alleviating pain, neurological symptoms, and potential damage.

Indications

• Persistent pain or discomfort in the back or neck
• Neurological deficits such as weakness, numbness, or tingling in the limbs
• Progressive symptoms of syringomyelia or cyst-related spinal cord compression
• Infections or previous interventions resulting in cyst formation

Preparation

• Patients may be instructed to fast for several hours before the procedure.
• Medication adjustments may be required, especially blood thinners.
• Pre-procedure imaging studies such as MRI or CT scans to locate the cyst or syrinx accurately.
• Routine blood tests and physical examination.

Procedure Description

1. The patient is positioned appropriately, often lying face down.
2. Local anesthesia is administered to numb the area.
3. Using live imaging guidance (e.g., fluoroscopy or ultrasound), a fine needle is inserted through the skin and tissues until it reaches the cyst or syrinx.
4. Fluid is aspirated (drawn out) from the cyst using a syringe.
5. The needle is removed, and a small bandage is applied to the site.

Duration

The procedure typically takes about 30 minutes to 1 hour.

Setting

It is usually performed in a hospital or an outpatient surgical center equipped with imaging technology.

Personnel

• Interventional radiologist or neurosurgeon
• Radiologic technologist
• Nurses
• Anesthesiologist, if necessary

Risks and Complications

• Infection at the puncture site
• Bleeding or hematoma formation
• Spinal cord injury, though rare
• Recurrence of the cyst or return of symptoms

Benefits

• Symptomatic relief from pain and neurological deficits
• Minimally invasive with shorter recovery time
• Less risk compared to open surgical methods

Recovery

• Post-procedure monitoring for a few hours
• Pain relief and comfort measures such as prescribed analgesics
• Instructions for wound care at the puncture site
• Possible restrictions on activity for a short period
• Follow-up appointments to monitor progress and for potential re-imaging

Alternatives

• Open surgical drainage or removal of the cyst
• Medications for symptom management
• Observation and regular imaging for non-symptomatic cases
• Pros and cons: Open surgery may provide more definitive treatment but comes with higher risk and longer recovery. Medications may not fully address the cause.

Patient Experience

During the procedure, patients typically feel pressure but should not experience pain due to local anesthesia. Post-procedure, mild discomfort at the site may occur, manageable with prescribed pain relievers. Recovery is generally quick, and most patients can resume normal activities within a few days, following medical advice.