A posttraumatic lumbar spinal synovial cyst

Franck, Joel I.; King, Robert B.; Petro, George R.; Kanzer, M. D.

doi:10.3171/jns.1987.66.2.0293

Cited by 66 publications

(40 citation statements)

References 22 publications

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“…On occasion, it may be located on the dorsal aspect of the facets and extend into the soft paravertebral tissues; in this event there are either no symptoms [31,45] or just low-back pain [2,40]. In one case the cyst is described as developing entirely within the ligamentum flavum, dissecting the fibers inside it [16].…”

Section: Discussionmentioning

confidence: 99%

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Cervical synovial cysts: case report and review of the literature

Lunardi

Acqui

Ricci

et al. 1999

European Spine Journal

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IntroductionSynovial cysts are cystic dilatations of the synovial sheaths; they are bordered not only by the connectival tissue structures of these sheaths but also by the mono-or pluri-stratified cuboid synovial epithelium. Anatomical continuity with the synovial sheaths of the joint cavities from which the cyst probably originates may not always be observed.While synovial cysts are quite a frequent occurrence in joints and tendon sheaths [3,10,23], especially in the joints of the hands and wrists [45], they are very rare in the spine [13,18,25,40,47,62]. In the lumbar spine 220 cases have been described [1,2,16,21,28,34,38,40,43,45,48,51,[54][55][56]60].The incidence of synovial cysts with a cervical location was evaluated, with reference to veterinary literature too [15], and was found to be an occurrence specific to humans, of which, to our knowledge, only 22 cases have been reported to date.We describe another case of cervical synovial cyst and discuss the pathological, etiopathogenetic, and clinical aspects of this rare pathology. Case reportA 58-year-old man was referred to us with a progressive spastic paraparesis, which had started 8 months earlier. About 2 months prior to admission, he had begun to suffer from genital-sphincteric ailments such as urinary retention and difficult erection.Examination revealed a severe motor deficit in the lower limbs (he was able to raise his legs while lying in bed for a few seconds only), as well as an increased response to knee and ankle jerks. There was superficial and deep hypoesthesia below C8 and apallesthesia below the iliac crests. There was also urinary retention, which required catheterization. AbstractThe authors describe the case of a 58-year-old man with a 6-month history of severe myelopathy. CT scan and MRI of the spine revealed a cystic formation, measuring about 1 cm in diameter, at C7-T1 at a right posterolateral site at the level of the articular facet. At operation the mass appeared to originate from the ligamentum flavum at the level of the articular facet and was in contact with the dura mater. Once the mass had been removed, there was a significant amelioration of the patient's symptoms. As previously suspected, histological aspect was synovial cyst. Cervical synovial cysts are extremely rare and, as far as we know, only 22 cases have so far been described in the literature. Diagnostic radiological investigations used were CT scan and MRI. At CT scan the most important diagnostic findings are a posterolateral juxtafacet location of the mass, egg-shell calcifications on the wall of the cyst, and air inside the cyst. At MRI the contents of the cyst are iso/hypointense on T1-and hyperintense on T2-weighted images. There may also be a hypointense rim on T2-weighted images, which enhances after i.v. administration of gadolinium. Surgical treatment consists of removal of the mass. Fixation of the vertebral segments involved is not always necessary.

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Section: Discussionmentioning

confidence: 99%

“…In the lumbar spine 220 cases have been described [1,2,16,21,28,34,38,40,43,45,48,51,[54][55][56]60].…”

Section: Introductionmentioning

confidence: 99%

Cervical synovial cysts: case report and review of the literature

Lunardi

Acqui

Ricci

et al. 1999

European Spine Journal

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“…Trauma is the next most common cause of the extradural lumbar spinal cyst. 10,14,18) Only one of our patients had a history of trauma after a recent accidental fall.…”

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confidence: 99%

Lumbar Synovial Cysts: Experience With Nine Cases

Ayberk

Ozveren

Gok

et al. 2008

Neurol. Med. Chir.(Tokyo)

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Nine patients treated surgically for lumbar spinal synovial cyst were reviewed. Four patients had synovial, two had ganglion, one had posterior longitudinal ligament, and two had ligamentum flavum cyst. Synovial cysts had a single layer of epithelial cells in the inner layer of the cyst with continuity with the facet joint. Ganglion cyst had no continuity with the facet joint and epithelial lining was present in one and absent in one case. Posterior longitudinal ligament and ligamentum flavum cysts had no continuity with the facet joint and no epithelial lining. Magnetic resonance imaging showed the cysts better than computed tomography. All patients treated for nerve root compression or lumbar spinal canal narrowing. One patient suffered recurrence 1 year later and was reoperated. Operative results were excellent in six and good in three patients. Lumbar spinal synovial cysts should be considered in differential diagnosis of lumbar radiculopathy/neurogenic claudication and is surgically treatable.

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“…Our patient was unusually young and, based on other reports describing the mechanism of excess stress such as motion and direct trauma, [2,7,18], the clinical history suggested that sport-(football-) related overactivity possibly caused partial distraction and injury of the left L4-5 facet joint, herniation of the synovial lining into the adjacent ligamentum flavum, and gradual proliferation and expansion of the cystic element by accumulation of viscous synovial fluid with acute haemorrhage, resulting in neurological symptoms.…”

Section: Yasuhisa Maezawa Hisatoshi Baba Kenzo Uchida Nobuaki Furusawmentioning

confidence: 99%

“…The majority of such cysts require surgical resection due to persistent radicular symptom and/or occasional pareses. [2,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. We report an unusual young patient in whom a symptomatic intraspinal juxta-articular cyst showed spontaneous remission through cessation of sport activity and immobilisation of the lumbar spine.…”

Section: Introductionmentioning

confidence: 99%