Medical treatment of synovial cysts of the zygapophyseal joints: Four cases with long‐term followup

Mariette, Xavier; Glon, Y; Clerc, D; Bennet, Pascal; Bisson, M

doi:10.1002/anr.1780320523

Cited by 23 publications

(11 citation statements)

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“…Conversely, progressive symptoms have been described in association with increasing cyst size [18,54]. Low back pain can be due to any combination of these factors or coexistent lumbar disc degenerative change [2,55]. Lumbar facet synovial cysts are sometimes an incidental finding and consideration of the clinical findings is essential in assessing the cause of pain [5].…”

Section: Discussionmentioning

confidence: 99%

MR imaging of lumbar facet joint synovial cysts

et al. 2000

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The increasing application of magnetic resonance (MR) imaging of the spine has raised the awareness of lumbar facet synovial cysts (LFSC). This well recognised, yet uncommon condition, presents with low back pain and radiculopathy due to the presence of an extradural mass. The commonest affected level is L4/5 with a mild degenerative spondylolisthesis a frequent associated finding. MR imaging is the technique of choice to detect and diagnose a LFSC. This pictorial essay, drawing on experience of 43 cases seen in 40 patients, illustrates the spectrum of appearances that can be encountered and suggest differing causes for the variable signal characteristics exhibited. Computed tomography (CT) can be of value in some cases to aid interpretation of the MR images. In addition, CT facet arthrography by injection of air or iodinated non-ionic contrast medium may be used to confirm the diagnosis in doubtful cases as well as noting whether the patients presenting symptoms can be provoked. A comprehensive review of the existing literature is presented.

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Section: Discussionmentioning

confidence: 99%

MR imaging of lumbar facet joint synovial cysts

et al. 2000

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“…2,7,9,10,18,21,22,24,26,27,33,34,43 Most patients with symptomatic synovial cysts of the lumbar spine present with radicular pain but not neurological deficits. 2,[5][6][7][8][9][10][11][12][13][16][17][18][21][22][23][24][25][27][28][29][30][31][32][33][34][35][36][37][38][39][40][41]43 A history of low-back pain invariably precedes the radicular pain. In addition to radiculopathy, patients may suffer from neurogenic claudication if the cyst becomes large enough to compromise the diameter of the spinal canal significantly.…”

Section: Intraspinal Location and Presentationmentioning

confidence: 99%

“…6,9,13,31 Several authors have reported cases of hemorrhage into the syn-ovial cyst. 22,26,29,31 Such a hemorrhage may cause an abrupt increase in the size of the cyst, which can result in pain either by nerve root compression or distension of the facet capsule.…”

Section: Intraspinal Location and Presentationmentioning

confidence: 99%

“…Several authors 8,9,18,21,23,29,30,35 have recommended injecting the facet joints with steroid agents. Bjorkengren, et al, 8 and Mariette, et al, 29 have both published reports on small series of patients with intraspinal synovial cysts treated with such injections.…”

Section: Treatment Optionsmentioning

confidence: 99%

“…Bjorkengren, et al, 8 and Mariette, et al, 29 have both published reports on small series of patients with intraspinal synovial cysts treated with such injections. Of a total of seven patients in whom the facet joint was injected with either methylprenisolone or triamcinolone, six reported complete resolution of symptoms by 2 weeks postinjections.…”

Section: Treatment Optionsmentioning

confidence: 99%

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Intraspinal synovial cysts: 10-year experience at the Ochsner Clinic

Howington¹,

Connolly²,

Voorhies³

1999

Journal of Neurosurgery: Spine

120

144

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Object. Although synovial cysts commonly involve the joints of the extremities, they are also found in the spinal canal. When symptomatic, they produce signs and symptoms consistent with nerve root and spinal cord compression. In this report the authors review the clinical presentations, radiological studies, and operative findings in 28 patients with intraspinal synovial cysts treated surgically at the Ochsner Clinic between 1988 and 1998. Methods. The medical records and radiological studies obtained in 28 patients (31 intraspinal synovial cysts) were analyzed. Twenty-nine (94%) of the cysts were located in the lumbar, one in the thoracic (T8–9), and one in the cervicothoracic (C7—T1) spine. Sixteen (57%) of the 28 patients presented with radicular pain. The remaining patients presented either with neurogenic claudication (25%) or with radicular pain and an associated neurological deficit (18%). Each cyst was located adjacent to a facet joint in which there was evidence of degenerative disease. Conclusions. Intraspinal synovial cysts are uncommon lesions most often found in the lumbar spine at the L4–5 level. They are invariably associated with facet degeneration and respond very well to surgical therapy.

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Juxtafacettenzysten als raumfordernde intraspinale Prozesse

et al. 1997

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Ganglionic and synovial cysts (juxta-facet cysts) causing nerve root compression are very rare. Magnetic resonance imaging is the best means of diagnosis. The treatment of choice is surgical removal of the cysts, though spontaneous remissions do occur. CT-guided aspiration of the cysts and corticosteroid injection can lead the symptoms to disappear, but only for a short time. In a retrospective study covering a period of 16.5 years, we discovered 24 juxta-facet cysts (10 ganglionic and 14 synovial cysts) with clinical symptoms in a total of 19,107 lumbar and thoracic operations performed to relieve nerve root compression: 16 cysts were located at the level L4-5,3 at the level L5-S1,2 at L3-4, and 1 each at the levels L2-3, L1-2, and T10-1. Seven patients complained of radicular pain, and the other 17 patients also had neurological deficits. Fourteen cysts were resected, and in 10 cases the lumbar disc was removed simultaneously. The average follow-up in 23 of the 24 patients was 26.6 months. Most (74%) of the patients became free of pain. Pareses disappeared in 89% and sensory deficits in 73% of cases.

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Medical treatment of synovial cysts of the zygapophyseal joints: Four cases with long‐term followup

Cited by 23 publications

References 1 publication

MR imaging of lumbar facet joint synovial cysts

MR imaging of lumbar facet joint synovial cysts

Intraspinal synovial cysts: 10-year experience at the Ochsner Clinic

Juxtafacettenzysten als raumfordernde intraspinale Prozesse

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