Highlights
- •Three cases of spinal synovial cysts treated surgically with satisfactory outcomes.
- •Gross total cystectomy should be achieved with the less extensive technique.
- •Presentation of a decision making algorithm for management of spinal synovial cysts.
Abstract
Synovial cysts constitute an uncommon degenerative lesion of the spine. They are usually
asymptomatic but they may also cause symptoms of variable severity. The authors present
three cases of such cysts, two in the lumbar region of a 55-year-old female and a
66 year old female and one in the cervical region of a 56-year-old male patient. All
patients presented with radiculopathy. Magnetic Resonance Images revealed a cystic
lesion at the L4/5 level in the first case, at L5/S1 level in the second case and
at the C7/T1 junction level in the third case. Treatment has been microsurgical resection
of all cysts with no post-operative complications and an excellent outcome. A discussion
of current management options for this unusual disease is presented and a decision
making flow chart is proposed.
Keywords
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References
- Retrospective study of 77 patients harbouring lumbar synovial cysts: functional and neurological outcome.Acta Neurochir (Wien). 2006; 148 (discussion 54): 47-54
- The role of spinal fusion in the treatment of cervical synovial cysts: a series of 17 cases and meta-analysis.J Neurosurg Spine. 2014; 21: 919-928
- Spinal lumbar synovial cysts. Diagnosis and management challenge.Eur Spine J. 2006; 15: 1176-1182
- Synovial cyst of the thoracic spine: case report.Arq Neuropsiquiatr. 2007; 65: 838-840
- Spinal synovial cysts: pathogenesis, diagnosis and surgical treatment in a series of seven cases and literature review.Eur Spine J. 2008; 17: 831-837
- Diagnosis and management of juxtafacet cysts.Neurosurg Focus. 2006; 20: E1
- Synovial cyst of spinal facet. Case report.J Neurosurg. 1974; 41: 372-376
- Degenerative intraspinal cyst of the cervical spine: case report and literature review.Spine (Phila Pa 1976). 2002; 27: E18-E22
- Radiculopathy due to spontaneous facetal cyst hemorrhage.J Craniovertebr Junction Spine. 2014; 5: 167-169
- Haemorrhagic lumbar synovial cyst. A cause of acute radiculopathy.J Bone Joint Surg Br. 2000; 82: 583-584
- Acute myelopathy caused by a cervical synovial cyst.J Korean Neurosurg Soc. 2014; 56: 55-57
- Recurrent back and leg pain and cyst reformation after surgical resection of spinal synovial cysts: systematic review of reported postoperative outcomes.Spine J. 2010; 10: 820-826
- Intradural invasion of lumbar synovial cyst. Case report.Neurol Med Chir (Tokyo). 2012; 52: 234-237
- Lumbar juxtafacet cyst resection: the facet sparing contralateral minimally invasive surgical approach.J Spinal Disord Tech. 2012; 25: E13-E17
- Synovial cyst at the C1–C2 junction in a patient with atlantoaxial subluxation.J Spinal Disord Tech. 2004; 17: 535-538
- Synovial cyst in the cervical region causing severe myelopathy.Yonsei Med J. 2004; 45: 539-542
- A series of 60 juxtafacet cysts: clinical presentation, the role of spinal instability, and treatment.J Neurosurg. 1996; 85: 560-565
- Intraspinal synovial cysts: natural history and diagnosis by CT.Radiology. 1982; 145: 375-376
- Treatment of spinal synovial cysts.World Neurosurg. 2013; 79: 375-380
- Lumbar hemorrhagic synovial cysts: diagnosis, pathogenesis, and treatment. Report of 3 cases.Surg Neurol. 2006; 65 (discussion 390): 385-390
- Epidural hematoma secondary to a rupture of a synovial cyst.Spine J. 2005; 5: 446-450
- Hemorrhagic lumbar synovial cyst.J Korean Neurosurg Soc. 2012; 52: 567-569
- Hemorrhagic lumbar synovial cyst: case report and literature review.Nagoya J Med Sci. 2015; 77: 481-492
- Migrating lumbar facet joint cysts.Skeletal Radiol. 2006; 35: 220-226
- Synovial cysts of the lumbar spine–pathological considerations and surgical strategy.Neurol Med Chir (Tokyo). 2013; 53: 95-102
- Brown-sequard syndrome caused by a cervical synovial cyst.J Korean Neurosurg Soc. 2014; 55: 215-217
- Case report. Atlantoaxial synovial cyst causing isolated unilateral hypoglossal nerve paralysis.Br J Radiol. 2010; 83: e35-e38
- Rare thoracolumbar facet synovial cyst presenting as paraparesis.Korean J Spine. 2015; 12: 193-195
- Microsurgical treatment of juxta facet cysts of the lumbar spine.J Spinal Disord Tech. 2006; 19: 155-160
- Facet arthrography of a cervical synovial cyst.J Neurointerv Surg. 2012; 4e17
- Spontaneous regression of symptomatic lumbar synovial cysts. Report of three cases.J Neurosurg. 2003; 99: 235-238
- The diagnosis and management of synovial cysts: Efficacy of surgery versus cyst aspiration.Surg Neurol Int. 2012; 3: S157-S166
- Management strategies for patients with spinal synovial cysts.World Neurosurg. 2013; 79: 277-280
- Surgical management of spinal synovial cysts: a series of 23 patients and systematic analysis of the literature.J Spinal Disord Tech. 2015; 28: 211-217
- Cervical degenerative intraspinal cyst: a case report and literature review involving 132 cases.BMJ Case Rep. 2012. 2012.;
- Surgical evaluation and management of lumbar synovial cysts: the Mayo Clinic experience.J Neurosurg. 2000; 93: 53-57
- Hemilaminoplasty for the treatment of lumbar intraspinal synovial cysts (LISCs) and literature review.Eur Spine J. 2016; 25: 3393-3402
- Treatment of facet cysts associated with neurogenic intermittent claudication with x-stop.J Spinal Disord Tech. 2013; 26: 218-221
- Minimally invasive surgical treatment of lumbar synovial cysts.Neurosurgery. 2004; 54 (107 111; discussion 111–2)
- Treatment of lumbar synovial cysts using minimally invasive surgical techniques.Neurosurg Focus. 2006; 20: E2
- Minimally invasive resection of lumbar intraspinal synovial cysts via a contralateral approach: review of 13 cases.J Neurosurg Spine. 2015; 23: 444-450
- Minimally Invasive Versus Open Surgery for Lumbar Synovial Cysts.World Neurosurg. 2017; 108: 555-559
- Minimally Invasive Tubular Resection of Lumbar Synovial Cysts: Report of 40 Consecutive Cases.World Neurosurg. 2016; 94: 188-196
Article info
Publication history
Published online: August 24, 2018
Accepted:
August 13,
2018
Received:
April 21,
2018
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
