Intraspinal synovial cysts: 10-year experience at the Ochsner Clinic

Abstract

Object. Although synovial cysts commonly involve the joints of the extremities, they are also found in the spinal canal. When symptomatic, they produce signs and symptoms consistent with nerve root and spinal cord compression. In this report the authors review the clinical presentations, radiological studies, and operative findings in 28 patients with intraspinal synovial cysts treated surgically at the Ochsner Clinic between 1988 and 1998. Methods. The medical records and radiological studies obtained in 28 patients (31 intraspinal synovial cysts) were analyzed. Twenty-nine (94%) of the cysts were located in the lumbar, one in the thoracic (T8–9), and one in the cervicothoracic (C7—T1) spine. Sixteen (57%) of the 28 patients presented with radicular pain. The remaining patients presented either with neurogenic claudication (25%) or with radicular pain and an associated neurological deficit (18%). Each cyst was located adjacent to a facet joint in which there was evidence of degenerative disease. Conclusions. Intraspinal synovial cysts are uncommon lesions most often found in the lumbar spine at the L4–5 level. They are invariably associated with facet degeneration and respond very well to surgical therapy.