Synovial Cysts of the Lumbar Spine

Ganau, Mario; Ennas, F.; Bellisano, Giulia; Ganau, Laura; Ambu, Rossano; Faa, Gavino; Maleci, Alberto

doi:10.2176/nmc.53.95

Cited by 40 publications

(8 citation statements)

References 38 publications

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“…This is seen as indirect evidence of the link between LSCs and instability [ 1 ]. Furthermore, previous studies have directly linked the occurrence of LSCs to the presence and severity of lumbar facet joint osteoarthritis [ 21 , 22 ] and lumbar spondylolisthesis [ 1 , 21 , 22 , 23 , 24 ], which is present as an associated condition in about 30–40% of cases [ 1 , 3 ]. Putative associations with a traumatic etiology have been discarded with the accumulation of cases in the literature [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Decompression with or without Fusion for Lumbar Synovial Cysts—A Systematic Review and Meta-Analysis

Benato

Menna

Rapisarda

et al. 2023

JCM

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The management of symptomatic lumbar synovial cysts (LSC) is still a matter of debate. Previous systematic reviews did not stratify data according to different treatment techniques or incompletely reported comparative data on patients treated with lumbar posterior decompression (LPD) and lumbar decompression and fusion (LDF). The aim of our study was to compare LPD and LDF via a systematic review and meta-analysis of the existing literature. The design of this study was in accordance with the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review questions were as follows: among patients suffering from symptomatic lumbar synovial cysts (population) and treated with either posterior lumbar decompression or posterior decompression with fusion (intervention), who gets the best results (outcome), in terms of cyst recurrence, reoperation rates, and improvement of postoperative symptoms (comparison)? The search of the literature yielded a total of 1218 results. Duplicate records were then removed (n = 589). A total of 598 articles were screened, and 587 records were excluded via title and abstract screening; 11 studies were found to be relevant to our research question and were assessed for eligibility. Upon full-text review, 5 were excluded because they failed to report any parameter separately for both LPD and LDF. Finally, 6 studies for a total of 657 patients meeting the criteria stated above were included in the present investigation. Our analysis showed that LDF is associated with better results in terms of lower postoperative back pain and cyst recurrence compared with LPD. No differences were found in reoperation rates and complication rates between the two techniques. The impact of minimally invasive decompression techniques on the different outcomes in LSC should be assessed in the future and compared with instrumentation techniques.

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Section: Discussionmentioning

confidence: 99%

Decompression with or without Fusion for Lumbar Synovial Cysts—A Systematic Review and Meta-Analysis

Benato

Menna

Rapisarda

et al. 2023

JCM

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“…These findings also give hope for the management of complex degenerative changes affecting the lumbosacral spine, especially in the elderly. Oftentimes, such patients present with axial pain due to abnormal facet loading at the lumbosacral junction, so that facet arthropathies may not be an isolated phenomenon and are commonly found together with evidence of synovial cysts and degenerative scoliosis [46,47,48]. Therefore, the minimal invasiveness of MBB and the positive results obtained, especially in degenerative disc disease at the L5–S1 level, would indicate the rationale for further clinical studies.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Response to a Medial Branch Block: MRI Analysis of the Lumbar Spine

Park

Kim

Seo³

et al. 2019

JCM

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The aim of this study was to determine the association between radiologic spinal pathology and the response to medial branches block (MBB). This retrospective observational study compared 165 patients. A successful response was defined as ≥30% or a 2-point reduction in the numeric rating scale (NRS) compared with the baseline at the 1-month follow-up. The facet angle, facet angle difference, facet joint degeneration, disc height and spondylolisthesis grade were analyzed from an MRI at the L3 to S1 levels. Univariate and multivariate logistic regression analyses were used to evaluate independent factors associated with a successful response of MBB. In the univariate analysis, the disc height at L5–S1 and facet angle difference at L3–4 were lower in the positive responders (p = 0.022 and p = 0.087, respectively). In the multivariate analysis, the facet angle difference at L3–4 and disc height at L5–S1 were independent factors associated with a successful response (odds ratio = 0.948; p = 0.038 and odds ratio = 0.864; p = 0.038, respectively). In patients with a degenerative disc at L5–S1, MBB can lead to a good response for at least one month. In patients with facet tropism at L3–4 level, the response to MBB after one month is likely to be poor.

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“…They are defined as fluid-filled collections lined by cyst wall and are found in the vicinity of facet synovial joints [1,4]. Synovial cysts in the spine have been identified more frequently in areas with greater mobility (e.g., L4-L5) and spondylolisthesis and may be products of spinal instability [2,5,6].…”

Section: Discussionmentioning

confidence: 99%

Bilateral Synovial Cysts as a Rare Cause of Myelopathy in a 38-year-old Woman

Mustroph

Cerecedo-López

Groff

et al. 2019

Cureus

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Synovial cysts are rare, and they occur even more rarely bilaterally or in the cervical spine. A 38-year-old previously healthy female presented with acute onset of numbness and tingling down her arms and weakness in her legs, which progressed steadily over 2-3 weeks to include significant gait disturbance. She denied bowel or bladder symptoms, saddle anesthesia, night sweats, weight loss, fever, or chills. MRI spine revealed a C7-T1 extradural mass consistent with bilateral synovial cysts emanating from bilateral neuroforamina resulting in critical spinal cord compression with T2 signal change in the cord. There was questionable patch enhancement after gadolinium contrast. The patient underwent C7-T1 laminectomies and partial bilateral medial facetectomies with excision of the cysts. Intraoperative cultures unexpectedly grew Staphylococcus aureus, suggesting superinfection of cysts. The patient recovered neurologic function postoperatively and was discharged on a 6-week course of IV antibiotics. We report and discuss the clinical presentation, pathogenesis, and neuroradiological findings in an adult case of bilateral synovial cysts at the C-T-spine junction. Immediate resection at symptom onset is indicated due to the good clinical outcome following resection and the real risk of paralysis if cysts are not excised in a timely fashion.

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Synovial Cysts of the Lumbar Spine

Cited by 40 publications

References 38 publications

Decompression with or without Fusion for Lumbar Synovial Cysts—A Systematic Review and Meta-Analysis

Decompression with or without Fusion for Lumbar Synovial Cysts—A Systematic Review and Meta-Analysis

Predictors of Response to a Medial Branch Block: MRI Analysis of the Lumbar Spine

Bilateral Synovial Cysts as a Rare Cause of Myelopathy in a 38-year-old Woman

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