Case study 52 - Learn about Synovial Cysts with Dr. Betsy Grunch - neurosurgeon

Case study 52 - synovial cyst

Synovial cysts are abnormal fluid-filled sacs in joints in the spine. These cysts are benign, which means they are not cancerous.

Synovial cysts typically develop as a result of degenerative changes that occur with aging. They can be found throughout the spine, but are most common in the lumbar region (low back).

The spine has many joints. Synovial cysts develop in the facet joints of the spine. These are the joints between the bony projections at the back of the vertebrae.

Symptoms depend on the size and location of the cyst.

Some patients may not experience any symptoms. However, some patients will experience back and leg pain that is better when sitting, and worse when standing and walking. This is because in a fully upright posture, the spinal canal naturally narrows, placing additional pressure on the spinal cord and nerve roots. The spinal canal naturally expands a bit when in a seated or flexed forward posture often relieving the excess pressure from spinal stenosis.

If the synovial cysts are large enough, they may cause spinal stenosis, or narrowing of the spinal canal. In spinal stenosis, the spinal canal becomes too narrow to allow the spinal cord and surrounding spinal nerves to move freely. As a result, patients may experience numbness, tingling or weakness in one or both legs.

The goal of surgical treatment is to remove the cyst and decompress (provide more room for) the spinal cord and nerve roots. This surgery is similar to a microdiscectomy.

After removing the cyst, the surgeon may need to fuse the affected joint. This procedure prevents the cyst from re-forming by preventing any movement at the affected joint. An example of this type of surgery is a lumbar fusion.

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