True synovial cysts of the lumbar spine: an epiphenomenon of instability of the functional spine unit?

Mattei, Tobias A.; Rodriguez, Abraham Hafiz

doi:10.1007/s10143-012-0443-9

Cited by 9 publications

(2 citation statements)

References 28 publications

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“…Synovial cysts are markers of spinal instability because of their association with facet joint disruption. 12 Symptomatic synovial facet cysts are those that grow to take up sufficient space in the spinal canal to cause nerve compression. Cervical and thoracic spinal synovial facet cysts may even cause patients to present with cervical radiculomyelopathy 13 and isolated myelopathy.…”

Section: Discussionmentioning

confidence: 99%

Acute development of spinal lumbar synovial facet cyst within 1 week after lumbar decompression: illustrative case

Sarmiento

Fourman

Lovecchio

et al. 2022

Journal of Neurosurgery: Case Lessons

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BACKGROUND Synovial facet cysts can sometimes develop in patients with lumbar spinal stenosis after decompressive laminectomy. The etiology of spinal lumbar synovial cysts is still unclear, but their formation is associated with underlying spinal instability, facet joint arthropathy, and degenerative spondylolisthesis. OBSERVATIONS A 61-year-old-male patient presented with neurogenic claudication due to lumbar spinal stenosis. Radiographic studies showed grade I spondylolisthesis and radiological predictors of delayed spinal instability. He underwent lumbar decompression and shortly thereafter developed spinal instability and recurrent symptoms, with formation of a new spinal lumbar synovial facet cyst. He required revisional decompression, cyst excision, and posterolateral spinal fusion for definitive treatment. LESSONS The literature reports postoperative spinal instability in up to one-third of patients with lumbar spinal stenosis and stable degenerative spondylolisthesis who undergo decompressive laminectomy. Close radiographic monitoring and early advanced imaging may be prudent in this patient population if they develop new postoperative neurological symptoms and show radiographic predictors of instability on preoperative imaging. Posterolateral spinal fusion with instrumentation should be considered in addition to lumbar decompression in this select group of patients who demonstrate radiographic predictors of delayed spinal instability if they are medically capable of tolerating a spinal fusion procedure.

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Section: Discussionmentioning

confidence: 99%

Acute development of spinal lumbar synovial facet cyst within 1 week after lumbar decompression: illustrative case

Sarmiento

Fourman

Lovecchio

et al. 2022

Journal of Neurosurgery: Case Lessons

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show abstract

“…If the decompression leads to significant facet disruption, then primary fusion must be performed [19]. There are several publications advocating fusion, although spinal fusion also increased the perioperative morbidity compared with decompression only, including incidental durotomies, wound infection, and deep venous thrombosis, decreasing cyst recurrence and unfavorable clinical outcome in the fusion group [19][20][21]. We always prefer to perform a vertebrae fusion in order to treat the segment instability and spinal degeneration which increase the chance of developing a yuxtaarticular facet cyst.…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Yuxta-articular Facet Cyst: A Case Report

Solera¹

2015

Trauma Cases Rev

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We report a case of 66 years-old male with left leg pain that began six months earlier. The pain was aggravated by sitting or climbing stairs but was relieved in the standing position. The physical examination was consistent with a left radiculopathy without sensory or motor deficit. His initial MRI lumbar spine demonstrated a cystic mass with T1 and T2 hyperintensity on the L3-L4 level with considerable thecal sac and nerve root compression. The lesion originated next to the left L3-4 facet joint and extended centrally under the lamina of L3 and L4. A surgical treatment was offered to the patient and subsequently underwent a left L3 hemilaminectomy, medial facetectomy, left ganglion excision and L3, L4 fusion, with a very satisfactory outcome.Spine ganglions are grouped within yuxta-articular facet cysts, along with synovial cysts. Etiology is unknown, but it is related with repeated trauma or microtrauma as a part of degenerative spinal disease. It is an uncommon pathology and 90% are located in the lumbar region. The most common symptom is pain and the radiculopathy, which is unusual; it will be due to compression of adjacent structures. Initial treatment is conservative. Surgery is indicated in cases where a neurological deficit exists or where conservative treatment fails in pain relief. Generally good results are described. In our case the patient had a very satisfactory outcome.

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Outcomes and complications following minimally invasive excision of synovial cysts of the lumbar spine: A systematic review and meta-analysis

Garg

Kasliwal

2021

Clinical Neurology and Neurosurgery

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True synovial cysts of the lumbar spine: an epiphenomenon of instability of the functional spine unit?

Cited by 9 publications

References 28 publications

Acute development of spinal lumbar synovial facet cyst within 1 week after lumbar decompression: illustrative case

Acute development of spinal lumbar synovial facet cyst within 1 week after lumbar decompression: illustrative case

Symptomatic Yuxta-articular Facet Cyst: A Case Report

Outcomes and complications following minimally invasive excision of synovial cysts of the lumbar spine: A systematic review and meta-analysis

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