Lumbar Synovial Cysts Research Articles

Unusual case of lumbar synovial cyst

Synovial cysts are extradural degenerative lesions associated with symptoms of lower back pain and radiculopathy. To our knowledge, all the reported cases of synovial cysts in literature were posterolateral in location (1–4). This case report describes the previously unreported midline location of the synovial cyst in the spinal canal and to increase the level of awareness of diagnosing these lesions in a central location, especially in light of the evaluation of lumbar radiculopathy.

Association of Lumbar Synovial Cysts with Facet Effusion

To show the frequent association of synovial cysts and facet effusion. MR studies of 26 patients with lumbar synovial cysts were reviewed for sex/age incidence, anatomic location, multiplicity of cysts and associated pathologies. All studies were reviewed for presence of facet effusion. 26 patients had 39 MRI documented synovial (17 females, 9 males). Age distribution: 41 – 79 years. Location of cysts: L4/5 = 29, L3/4 = 6, L5/S1 = 3, L1/2= −;1. 36 synovial cysts showed facet effusion. 19 patients also had facet effusions at adjoining motion segments or at contralateral joints. Synovial cysts were found in anterior (n=20), posterior (n=13), anterior-posterior (n=3) positions. 18 patients had cysts localized to one single facet joint, 8 patients showed synovial cysts at multiple facet joints. The frequent coexistence of synovial cysts and facet effusion in our material suggests a causal relationship. External herniation of synovium from a fluid expanded joint space appears to be the most plausible pathologic mechanism.

Case report: Acute radiculopathy due to a haemorrhagic lumbar synovial cyst

Intraspinal synovial cysts are uncommon entities associated with facet joint degeneration. Clinically the most frequent presentation is with intermittent lower back pain without motor or sensory impairment, although more classical radicular symptoms and an acute exacerbation of symptoms may occur due to intracystic haemorrhage. Previous reports include MR images from only two cases of pathologically proven haemorrhagic cysts. We report a case of acute radiculopathy shown on MR to be due to a cystic lesion adjacent to the right L4/5 facet joint and which was surgically proven to be a haemorrhagic synovial cyst. The literature on this condition is reviewed.

Lumbar-sacral radiculopathy secondary to intraspinal synovial cyst

Objective: The presentation of a patient with acute low back pain and distal radiation to the lower extremities is often attributed to a herniated nucleus pulposus (NHP). The purpose of this report is to illustrate how an intraspinal lumbar synovial cyst can have a similar presentation. Case Presentation: A 52-year-old man presented with low back pain with left lower extremity weakness and distal radiation. An electrodiagnostic evaluation was consistent with lumbar-sacral radiculopathy. Computed tomography and magnetic resonance imaging showed a synovial cyst of the L4-5 facet joint. Intervention: The patient underwent a L4-L5 laminotomy, synovial cyst excision, and decompression of the L5 nerve root. Results: There were no postoperative complications. The patient had residual left lower extremity numbness but gradually regained the strength of his left lower extremity. Intraspinal synovial cyst can mimic the clinical pattern of NHP. Conclusion: An intraspinal lumbar synovial cyst can present with symptoms of nerve root compression. Given the presentation of lumbar-sacral radicular symptoms such as radiating pain, muscle weakness, and numbness, surgical excision of the lumbar synovial cyst remains the definitive treatment of choice.

Synovial cysts of the lumbar spine: Diagnosis, surgical management, and pathogenesis: Report of eight cases

BACKGROUND Synovial cysts are uncommon extradural degenerative lesions associated with symptoms of lower back pain and radiculopathy. Most of these lesions occur in the lumbar spine at the L4-5 level and to a lesser extent at the L5-S1 and L3-4 levels. METHODS A retrospective study involving eight patients seen by the neurosurgery service from January 1, 1989, to May 30, 1994, was analyzed. The type, duration, and distribution of symptoms were evaluated, along with the patient's age and sex. All patients had lumbosacral spine x rays and magnetic resonance imaging. Four had a computed tomography-myelogram of the lumbar spine. All patients underwent a laminectomy or hemilaminectomy and cyst excision, and all were followed for a minimum of 1 year. The presence of a synovial cyst was confirmed by histopathology. RESULTS Of the eight patients, seven had dramatic pain relief with five having complete resolution of pain. The single care of persistent pain was found to be due to scar tissue at the operative site. All five cases of preoperative lower extremity weakness showed complete resolution. Dysesthesia was either unchanged or decreased. CONCLUSIONS Surgery is a safe, effective treatment for patients with lumbar synovial cysts and is the treatment of choice for these lesions.

INTRASPINAL LUMBAR SYNOVIAL CYST

In conclusion, intraspinal lumbar synovial cysts are uncommon causes of sciatic pain. Intraspinal synovial cysts are associated with degenerative arthritis of the lumbar spine. The radiographic findings on myelography are non-specific, but CT and MRI are helpful in establishing the diagnosis and in differentiating synovial cysts from other extradural lesions.

Lumbar synovial cyst associated with retrolithesis: a case report

In advant of high-resolutional CT and MRI, it is not so difficult to detect the lumbar synovial cyst, however the unusual disease should be included in the differential diagnosis of cauda equina compression syndromes. The case of a 55-year-old man who had a low back pain and severe radiating pain on both legs showed a retrolisthesis at L3-4 and L4-5 and epidural enhansing mass just around L4-5 facet joint on MRI. Microscopically a lining of synovial tissue was demonstrated. After surgery of the total resection of synovial cyst and stabilization, the patient's presenting symptoms were improved.

The Advantage of Magnetic Resonance Imaging in Diagnosis of a Lumbar Synovial Cyst

The Advantage of Magnetic Resonance Imaging in Diagnosis of a Lumbar Synovial Cyst

Lumbar synovial cysts

Lumbar synovial cysts

The hypertelorism microtia clefting syndrome

<h3>BACKGROUND AND PURPOSE:</h3> Lumbar facet synovial cysts are commonly seen in facet degenerative arthropathy and may be symptomatic when narrowing the spinal canal or compressing nerve roots. The purpose of this study was to analyze the safety, effectiveness, and long-term outcomes of direct CT-guided lumbar facet synovial cyst aspiration and fenestration for symptom relief and for obviating an operation. <h3>MATERIALS AND METHODS:</h3> We retrospectively reviewed the medical records and imaging studies of 64 consecutive patients between 2006 and 2016 who underwent 85 CT-guided lumbar facet synovial cyst fenestration procedures in our department. We recorded patient demographics, lumbar facet synovial cyst imaging characteristics, presenting symptoms, change in symptoms after the procedure, and whether they underwent a subsequent operation. We also assessed long-term outcomes from the medical records and via follow-up telephone surveys with patients. <h3>RESULTS:</h3> Direct CT-guided lumbar facet synovial cyst puncture was technically successful in 98% of procedures. At first postprocedural follow-up, 86% of patients had a complete or partial symptomatic response. During a mean follow-up of 49 months, 56% of patients had partial or complete long-term relief without the need for an operation; 44% of patients underwent an operation. Patients with calcified, thick-rimmed, or low T2 signal intensity cysts were less likely to respond to the procedure and more likely to need an operation. <h3>CONCLUSIONS:</h3> CT-guided direct lumbar facet synovial cyst aspiration and fenestration procedures are safe, effective, and minimally invasive for symptomatic treatment of lumbar synovial facet cysts. This procedure obviates an operation in a substantial number of patients, even at long-term follow-up, and should be considered before surgical intervention.