Lumbar Synovial or Ganglion Cysts

Kjerulf, Terrell D.; Terry, Daniel W.; Boubelik, Richard J.

doi:10.1227/00006123-198609000-00013

Cited by 107 publications

(11 citation statements)

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“…Contrary to juxta-facet cysts, there have been only a few cases of ligamentum flavum cysts described in the literature. [3][4][5][6][7][8][9][10][11][12][13][14][15] The majority of published cases involved the lower lumbar spine, and corroborate the notion that ligamentum flavum cysts may be associated with microtrauma in the form of increased mobility at this level, 16,17 with associated spinal degeneration. 18 The majority of patient series in the literature regarding juxtafacet cysts demonstrate that facet joint degeneration is virtually always co-present, and the incidence of degenerative spondylolisthesis varies between 42 and 65%.…”

Section: Discussionmentioning

confidence: 59%

Ligamentum Flavum Cysts Causing Incapacitating Lumbar Spinal Stenosis

DiMaio

Marmor²,

Albrecht³

et al. 2005

Can. j. neurol. sci.

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c c n s . o r gCysts of the ligamentum flavum are unusual causes of spinal compression. Their etiology and histopathologic classification have yet to be fully elucidated. We report our experience of four cases of ligamentum flavum cysts occurring in the lumbar spine and discuss some of the etiologies and possible pathophysiologic mechanisms for their development. CASE REPORTSAn outline of the cases is contained in the Table, and imaging examples are shown in Figure 1. Case 1The patient was an 82-year-old woman referred for recent onset of right-sided sciatica involving mostly the S1 distribution and causing major incapacitation because of severe pain. There was no pain on coughing; however, she had increased urinary frequency at night. On examination, motor function was normal and there was no sensory disturbance on examination of the legs. Reflexes were hypoactive in the right leg with plantar reflexes downgoing.Computerized tomography (CT) imaging of the lumbo-sacral spine showed significant degenerative disease in the lumbar spine, as well as an epidural mass occupying the L5-S1 region, with a small posterocentral subligamentous hernia, possibly representing a synovial or arachnoid cyst but also compatible with a benign cystic tumour such as a schwannoma. Subsequent magnetic resonance imaging (MRI) demonstrated a voluminous epidural cystic lesion compressing the cauda equina to the right of the sac at L5-S1, compatible with a synovial cyst of the ligamentum flavum. In light of the acuity and degree of incapacitation of the disease, the patient was hospitalized for urgent laminectomy with microsurgical removal of the cyst.ABSTRACT: Background: Cysts of the ligamentum flavum are rare and unusual causes of spinal compression. Methods: We report our experience of four cases of ligamentum flavum cysts occurring in the lumbar spine and discuss some of the possible etiologies and pathophysiologic mechanisms according to the available literature. Conclusion: This entity is clearly different from the synovial facetjoints or ganglion cysts.RÉSUMÉ: Sténose spinale lombaire incapacitante causée par un kyste du ligament jaune. Introduction: Les kystes du ligament jaune sont rares et causent très rarement une compression spinale. Méthodes: Nous rapportons notre expérience au sujet de quatre cas de kystes du ligament jaune au niveau lombaire et nous discutons de l'étiologie et de la physiopathologie de cette entité à la lumière de la littérature actuelle. Conclusion: Cette pathologie est nettement différente des kystes synoviaux des articulations facettaires ou des kystes ganglionnaires.

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Section: Discussionmentioning

confidence: 59%

Ligamentum Flavum Cysts Causing Incapacitating Lumbar Spinal Stenosis

DiMaio

Marmor²,

Albrecht³

et al. 2005

Can. j. neurol. sci.

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“…1,2 Histologically, two types of intraspinal cysts have been recognised in humans: synovial cysts and ganglion cysts. Synovial cysts are the result of synovial outpouchings through weakened capsular tissue and have a synovium-like epithelial lining, whereas ganglion cysts arise from mucinous degeneration of periarticular connective tissue and contain myxoid material with a fibrous wall.…”

Section: Discussionmentioning

confidence: 99%

“…The lesion was therefore consistent with a cyst, with an intraspinal ganglion cyst being considered the most likely diagnosis, based on previous classification. 1,2 The cat recovered uneventfully, showing rapid and progressive signs of improvement, and was discharged 3 days after surgery. At 1 month follow-up the cat was showing occasional episodes of discomfort and mild stiffness on pelvic limbs; no neurological deficits were present on neurological assessment performed 2 and 3 months later.…”

Section: Case Descriptionmentioning

confidence: 97%

Lumbosacral intraspinal extradural ganglion cyst in a cat

Strobel

Taeymans

Rosati³

et al. 2015

Journal of Feline Medicine and Surgery Open Reports

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Case summaryA 16-year-old neutered female domestic shorthair cat was referred for chronic history of reluctance to jump, stiffness of the tail and lower back pain. Mild pelvic limb ataxia, reduced perianal reflex and lumbosacral discomfort were present on neurological examination. On magnetic resonance imaging, a well-defined rounded structure of 3 mm in diameter was identified on the right dorsal aspect of the epidural space at L7–S1, causing displacement of the cauda equina. The lesion was hyperintense to spinal cord parenchyma on T2-weighted images and hypointense on T1-weighted images, consistent with a fluid-filled structure. A Lumbosacral dorsal laminectomy was performed. A clear fluid-containing structure was identified between the right L7 nerve root and the cauda equina. Following surgical excision, histopathology confirmed the cystic nature of the lesion and revealed thick disorganised sheaths of fibrocollagenous tissue and flattened mesenchymal cells lining the luminal part of the cyst wall. A diagnosis of intraspinal ganglion cyst was made. The cat recovered uneventfully. Seven months after surgery euthanasia was performed for unrelated reasons; no neurological deficits were present.Relevance and novel informationThis is the first reported case of intraspinal ganglion cyst in a cat. Intraspinal extradural cysts should be considered among other differential diagnoses for cats with lumbosacral myelopathy/radiculopathy.

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“…Synovial cyst is a common lesion that occurs typically in the extremities, especially at the wrist, knee, ankle, and foot. 9 Reports of juxtafacet cysts of the spine are becoming more common, partly due to the improved sensitivity of neuroradiological investigations. 1 In the spine, these lesions are most common in the lumbar (L4-L5) segment and are usually associated with osteoarthritis of the adjacent facet joint.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Hemorrhage in an Upper Lumbar Synovial Cyst Causing Subacute Cauda Equina Syndrome

Machino¹,

Yukawa²,

Ito³

et al. 2012

Orthopedics

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Lumbar spine synovial cysts are becoming more frequent, and they are generally associated with degenerative lumbar spinal disease. They are common in lower lumbar lesions but rare in upper lumbar lesions. Several cases of hemorrhage into lower lumbar juxtafacet cysts after trauma or anticoagulation therapy have been reported in the literature. This article describes a case of subacute cauda equina syndrome resulting from spontaneous hemorrhage into an upper lumbar synovial cyst. A 65-year-old man presented with a 3-month history of intermittent bilateral lumbar pain. One week before, he experienced a sudden exacerbation of lumbar pain and began falling frequently; he also reported weakness and tingling in his lower limbs. A hematic collection associated with a large juxtafacet cyst at L2-L3 was suspected on magnetic resonance imaging. He underwent surgical decompression, and the cyst was resected. Microscopic examination was consistent with the diagnosis of a synovial cyst. Two days postoperatively, he was walking independently. Although several descriptions exist of hemorrhagic lumbar juxtafacet cysts after trauma or anticoagulant therapy, to the authors' knowledge, this is the first documented case of hemorrhage in an upper lumbar synovial cyst with no previous traumatic event or medication use. Magnetic resonance imaging was essential in making the preoperative diagnosis. Surgical removal of the cyst was an effective treatment.

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Lumbar Synovial or Ganglion Cysts

Cited by 107 publications

References 0 publications

Ligamentum Flavum Cysts Causing Incapacitating Lumbar Spinal Stenosis

Ligamentum Flavum Cysts Causing Incapacitating Lumbar Spinal Stenosis

Lumbosacral intraspinal extradural ganglion cyst in a cat

Spontaneous Hemorrhage in an Upper Lumbar Synovial Cyst Causing Subacute Cauda Equina Syndrome

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