The appearances of lumbar intraspinal synovial cysts

Knox, A.M.; Fon, Gerald T.

doi:10.1016/s0009-9260(05)80658-0

Cited by 43 publications

(25 citation statements)

References 22 publications

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“…Conservative treatment consists of bed rest, analgesics plus anti-inflammatory drugs, physical therapy, bracing, transcutaneous electrical stimulation, epidural or intra-articular steroid injections, and computed tomography-guided fine needle aspiration and arthrography [25][26][27]. Surgical treatments include resection or fusion [28,29].…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics of intraspinal facet cysts following microsurgical bilateral decompression via a unilateral approach for treatment of degenerative lumbar disease

et al. 2013

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Purpose Primary intraspinal facet cysts in the lumbar spine are uncommon, but it is unclear whether cyst incidence increases following decompression surgery and if these cysts negatively impact clinical outcome. We examined the prevalence, clinical characteristics, and the risk factors associated with intraspinal facet cysts after microsurgical bilateral decompression via a unilateral approach (MBDU). Methods We studied 230 patients treated using MBDU for lumbar degenerative disease (133 men and 97 women; mean age 70.3 years). Clinical status, as assessed by the Japanese Orthopedic Association (JOA) score and findings on X-ray and magnetic resonance images, was evaluated prior to surgery and at both 3 months and 1 year after surgery. The prevalence of intraspinal facet cysts was determined and preoperative risk factors were defined by comparing presurgical findings with clinical outcomes. Results Thirty-eight patients (16.5 %) developed intraspinal facet cysts within 1 year postoperatively, and 24 exhibited cysts within 3 months. In 10 patients, the cysts resolved spontaneously 1 year postoperatively. In total, 28 patients (12.2 %) had facet cysts 1 year postoperatively. The mean JOA score of patients with cysts 1 year postoperatively was significantly lower than that of patients without cysts. This poor clinical outcome resulted from low back pain that was not improved by conservative treatment. Most cases with spontaneous cyst disappearance were symptom-free 1 year later. The preoperative risk factors for postoperative intraspinal facet cyst formation were instability (OR 2.47, P = 0.26), scoliotic disc wedging (OR 2.23, P = 0.048), and sagittal imbalance (OR 2.22, P = 0.045). Conclusions Postoperative intraspinal facet cyst formation is a common cause of poor clinical outcome in patients treated using MBDU.

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Section: Discussionmentioning

confidence: 99%

Clinical characteristics of intraspinal facet cysts following microsurgical bilateral decompression via a unilateral approach for treatment of degenerative lumbar disease

et al. 2013

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“…3,7,12,17,27) In the present case, we could not definitely confirm that synovial cyst was the causative pathology based only on the findings of MR imaging and CT. CT showed a small amount of gas in the mass. Gas-filled synovial cysts have been reported, presumably originating from the contiguous vacuum in the facet joint, 1,10,11,15,18,24,25) but the diagnostic value is limited due to the polymorphism of radiologic presentation of synovial cysts and lack of sensitivity of CT. 21) Surgery has been considered for the treatment of symptomatic lumbar synovial cyst. Conservative treatments including percutaneous needle aspiration of the synovial cyst and intra-articular steroid injection have been advocated, but the outcome of surgical excision has been superior to nonsurgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Intradural Invasion of Lumbar Synovial Cyst

Bae

Lee

Kim

et al. 2012

Neurol. Med. Chir.(Tokyo)

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A 63-year-old female presented with a rare case of synovial cyst invading the dura mater and mimicking an intradural extramedullary tumor in the lumbar spine. She underwent posterior lumbar fusion with laminar wire fixation from L3 to S1 levels. She complained of severe pain along the anterolateral thigh in both legs for 1 year. Radiological examinations, including magnetic resonance imaging and computed tomography revealed an intradural extramedullary lesion at the L2-3 level that was compressing the thecal sac. Histological examination confirmed a synovial cyst. Synovial cyst should be considered in the differential diagnosis of an intradural extramedullary mass causing lumbar radiculopathy.

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“…The neuroradiological appearance of lumbar synovial cysts is that of a cystic lesion originating from the medial tip of the articular facets [11,17,18,22].…”

Section: Discussionmentioning

confidence: 99%

“…The usual CT appearance is that of a cystic structure adjacent to a degenerated facet joint, often with a calcified rim. Some authors [5,22,31] have reported a CT finding of gas surrounded by cyst density, presumably originating from the contiguous vacuum in the facet joint. We also observed this aspect in one of our cases.…”

Section: Discussionmentioning

confidence: 99%

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Synovial cysts: Clinical and neuroradiological aspects

et al. 1997

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Lumbar and intraneural synovial cysts are uncommon lesions, although their incidence has increased since the introduction of MRI. The authors describe the results of a study comprising 23 patients with synovial cyst (5 lumbar, 19 intraneural). Neuroradiological investigations included CT scan and MRI; however, it was not always possible to diagnose the nature of the lesion. In 18 cases the lesion was removed totally including its capsule; in the other 5 cases it was removed subtotally. Seven of the 23 patients presented a total remission of symptoms/signs, 11 improved and 5 remained unchanged. The importance of treating synovial cysts as radically as possible is discussed together with their most significant clinical and neuroradiological aspects.

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The appearances of lumbar intraspinal synovial cysts

Cited by 43 publications

References 22 publications

Clinical characteristics of intraspinal facet cysts following microsurgical bilateral decompression via a unilateral approach for treatment of degenerative lumbar disease

Clinical characteristics of intraspinal facet cysts following microsurgical bilateral decompression via a unilateral approach for treatment of degenerative lumbar disease

Intradural Invasion of Lumbar Synovial Cyst

Synovial cysts: Clinical and neuroradiological aspects

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