Correlation between the Symptomatic Lumbar Synovial Cyst and Facet Degeneration: Retrospective Study of 13 Surgical Cases

최진규,류경식,이홍재,이기열,박춘근 대한척추신경외과학회 2011 Neurospine Vol.8 No.2

Objective: This retrospective study of 13 patients who underwent surgical treatment for symptomatic lumbar synovial cyst was performed to evaluate the clinical findings and pathogenesis of lumbar synovial cyst. Methods: The clinical characteristics of the patients were investigated by reviewing the hospital records, preoperative radiological images, and operation records. By observing preoperative CT scans Facet degeneration grade at the lesion and opposite side of pathologic level and adjacent levels were assessed and compared. Results: There were 5 males and 8 females (average 65.8 year-old). Six patients presented with low back pain and leg pain, and 7 patients presented only leg pain. Most common pathologic level was L4-5. All patients nderwent the cyst resection with/without decompressive laminectomy or discectomy. The additional instrumentation was not performed in all patients. No complications or recurrence was observed during average 34.5 months follow-up. There was no significant difference of facet degeneration grade between the lesion side of pathologic level and opposite side of same level or lower adjacent level. Conclusion: In the present study, all patients showed clinical improvement by the simple surgery without any instrumentation. No significant correlation between the occurrence of synovial cyst and the degeneration grade of facet joint was revealed. Objective: This retrospective study of 13 patients who underwent surgical treatment for symptomatic lumbar synovial cyst was performed to evaluate the clinical findings and pathogenesis of lumbar synovial cyst. Methods: The clinical characteristics of the patients were investigated by reviewing the hospital records, preoperative radiological images, and operation records. By observing preoperative CT scans Facet degeneration grade at the lesion and opposite side of pathologic level and adjacent levels were assessed and compared. Results: There were 5 males and 8 females (average 65.8 year-old). Six patients presented with low back pain and leg pain, and 7 patients presented only leg pain. Most common pathologic level was L4-5. All patients nderwent the cyst resection with/without decompressive laminectomy or discectomy. The additional instrumentation was not performed in all patients. No complications or recurrence was observed during average 34.5 months follow-up. There was no significant difference of facet degeneration grade between the lesion side of pathologic level and opposite side of same level or lower adjacent level. Conclusion: In the present study, all patients showed clinical improvement by the simple surgery without any instrumentation. No significant correlation between the occurrence of synovial cyst and the degeneration grade of facet joint was revealed.

Hemorrhagic Synovial Cyst in the Cervical Spine: A Case Report and Review of Literature

Tae Hyeong Kim,Min Soo Kim,박은석,Jun Bum Park,Soon Chan Kwon,In Uk Lyo,Hong Bo Sim 대한말초신경학회 2017 The Nerve Vol.3 No.2

Synovial cysts of the cervical spine are rare entities and intra-cystic hemorrhage have been described in a few of these cases. Traumatic or non-traumatic origins of acute bleeding into the cyst cavity resulting in cyst enlargement and epidural compression have been reported. A 74-year-old woman presented with a 1-year history of bilateral leg weakness that has worsened within the recent couple of weeks. The spine magnetic resonance imaging revealed a heterogeneously enhanced mass which has compressed the spinal cord posteriorly at the C7-T1 level. A cervical laminectomy and removal of the mass were performed. Intra operative examination revealed that the mass contained a hematoma. The histology showed a hemorrhagic synovial cyst. The patient’s neurological condition slowly improved to stick-assisted gait after the surgical decompression. We present a case of lower cervical (C7-T1) synovial cyst with acute bleeding and sudden increase in the size of the lesion with spinal cord compression as well as a review of literature.

Acute Myelopathy Caused by a Cervical Synovial Cyst

Kim, Dong Shin,Yang, Jin Seo,Cho, Yong Jun,Kang, Suk Hyung The Korean Neurosurgical Society 2014 Journal of Korean neurosurgical society Vol.56 No.1

Synovial cysts of the cervical spine, although they occur infrequently, may cause acute radiculopathy or myelopathy. Here, we report a case of a cervical synovial cyst presenting as acute myelopathy after manual stretching. A 68-year-old man presented with gait disturbance, decreased touch senses, and increased sensitivity to pain below T12 level. These symptoms developed after manual stretching 3 days prior. Computed tomography scanning and magnetic resonance imaging revealed a 1-cm, small multilocular cystic lesion in the spinal canal with cord compression at the C7-T1 level. We performed a left partial laminectomy of C7 and T1 using a posterior approach and completely removed the cystic mass. Histological examination of the resected mass revealed fibrous tissue fragments with amorphous materials and granulation tissue compatible with a synovial cyst. The patient's symptoms resolved after surgery. We describe a case of acute myelopathy caused by a cervical synovial cyst that was treated by surgical excision. Although cervical synovial cysts are often associated with degenerative facet joints, clinicians should be aware of the possibility that these cysts can cause acute neurologic symptoms.

Synovial Cyst of the Temporomandibular Joint : Case Report

박재홍,김도형,최소영,이성탁 대한구강악안면병리학회 2023 대한구강악안면병리학회지 Vol.47 No.4

Synovial cysts of the temporomandibular joint are rare. They commonly occur in the wrist, knee and feet. The main symptoms of synovial cysts occurring in the temporomandibular joint include preauricular pain and swelling, and surgical removal is the gold-standard treatment. A 54-year-old woman who presented with swelling of the right temporomandibular joint visited Kyungpook National University Dental Hospital. She had undergone enhanced computed tomography from another hospital, which showed a 1.1 × 0.8 × 1 cm well-defined rounded cystic lesion on the lateral area of the right temporomandibular joint. A synovial or ganglion cyst was suspected. The cystic lesion was surgically removed under general anesthesia and was histopathologically diagnosed as a synovial cyst. Histopathological findings show a lumen surrounded by loose fibrous tissue, and the lining is in a folded form and is composed of synovial cells.

Juxtafacet Spinal Synovial Cysts

Haitham El-Beltagy Abd El-Kader 대한척추외과학회 2016 Asian Spine Journal Vol.10 No.1

Study Design: This was a retrospective study. Purpose: To study the surgical outcome of synovial cysts of the lumbar spine through posterior laminectomy in combination with transpedicular screw fixation. Overview of Literature: Synovial cysts of the lumbar spine contribute significantly to narrowing of the spinal canal and lateral thecal sac and nerve root compression. Cysts form as a result of arthrotic disruption of the facet joint, leading to degenerative spondylolisthesis in up to 40% of patients. Methods: Retrospective data from 6 patients, treated during the period of March 2007 to February 2011, were analyzed. All preoperative and postoperative manifestations, extension/flexion radiographs, magnetic resonance imaging, and computed tomography records were reviewed. All underwent surgery for synovial cysts with excision and decompression combined with posterior fixation. The result of surgery was evaluated with Macnab’s classification. An excellent or good outcome was considered as satisfactory. Japanese Orthopedic Association Scale was used for evaluation of back pain. Results: All patients included in this study had excellent outcomes as regarding to improvement of all preoperative manifestations and returning to normal daily activities. Only 2 cases developed postoperative transient cerebro-spinal fluid leak and were treated conservatively and improved during the follow up period. Conclusions: Although this study included a small number of cases and we could not have statistically significant results, the good outcome of decompression of synovial cysts combined with posterior fixation and fusion encouraged us to recommend this approach for patients with juxtafacet synovial cysts.

Lumbar Intraspinal Extradural Ganglion Cysts

Cho, Sung-Min,Rhee, Woo-Tack,Choi, Soo-Jung,Eom, Dae-Woon The Korean Neurosurgical Society 2009 Journal of Korean neurosurgical society Vol.46 No.1

The lumbar intraspinal epidural ganglion cyst has been a rare cause of the low back pain or leg pain. Ganglion cysts and synovial cysts compose the juxtafacet cysts. Extensive studies have been performed about the synovial cysts, however, very little has been known about the ganglion cyst. Current report is about two ganglion cysts associated with implicative findings in young male patients. We discuss about the underlying pathology of the ganglion cyst based on intraoperative evidences, associated disc herniation at the same location or severe degeneration of the ligament flavum that the cyst originated from in young patients.

자연 소실된 요추 추간관절 낭종 1례

이종철,강석형,박승원 대한척추신경외과학회 2010 Neurospine Vol.7 No.3

There have been many reports about lumbar synovial cysts, discussing surgical or interventional treatment methods. Howe- ver, there have been few reports about spontaneous regression of the cyst. We report a case of a lumbar synovial cyst that regressed spontaneously. To the best of our knowledge, this is the first report of a spontaneously regressed lumbar synovial cyst in Korea. The patient was a 59-year-old man who presented with a 6-month history of insidious pain onset in the lower back and right buttock. Upon MRI of the lumbar spine, grade 1 spondylolisthesis was revealed at the L4-5 level. An about 6mm-sized extradural cyst was detected at the medial side of the right L4-5 facet joint. His symptoms were disappeared upon facet block with 0.5% bupivacaine bilaterally at the L4-5 level. Six years later, he revisited our clinic due to low back pain and left leg radiating pain. Upon lumbar MRI, aggravated L4-5 spondylolisthesis with left-side disc protrusion was observed. However, we could not find the synovial cyst around the right L4-5 facet joint that had existed 6 years prior. The patient was treated conservatively because he refused surgery.

측두하악관절에 발생된 양측성 활액낭의 증례

유지용,최은주,이병도,윤정훈,이완 대한구강악안면병리학회 2016 대한구강악안면병리학회지 Vol.40 No.6

Synovial cysts are found mainly in periarticular areas of the wrist, ankle, and knee, but also rarely in the temporomandibular joint (TMJ). Only 1 case of bilateral synovial cysts in the region of the TMJ has been reported. This case report described bilateral cysts in the TMJ in a 54-year-old Korean woman. T2-weighted magnetic resonance imaging (MRI) revealed bilateral oval cystic lesions lateral to the condylar capsule, whereas computed tomography (CT) apparently did not show the right hand side lesion. The cyst on the left side was surgically excised, and fine needle aspiration was performed on the right hand cyst. After 24 months, the long term follow-up showed no sign of recurrence.

Foraminal Synovial Cyst Associated with Ankylosing Spondylitis

Kim, Heyun-Sung,Ju, Chang-Il,Kim, Seok-Won The Korean Neurosurgical Society 2011 Journal of Korean neurosurgical society Vol.50 No.1

Ankylosing spondylitis (AS) is frequently associated with inflammatory lesions of the spine and continuous fatigue stress fractures; however, an association with an intraspinal synovial cyst has not been previously reported. A 55-year-old man with a five year history of AS who presented with back pain and a right radiculopathy was admitted to the hospital. Five years previously, he underwent a percutaneous vertebroplasty for an osteoporotic L1 compression fracture, and was diagnosed with AS at that time. Plain radiographs showed aggravated kyphosis and a stress fracture through the ossified posterior element, below the prior vertebroplasty. Magnetic resonance images revealed a right foraminal cystic lesion at the L2-L3 level with effacement of the nerve root. A 1.6 cm cystic lesion that appeared to arise from the L2-L3 facet joint without direct communication was excised from the L2-L3 foramen. Pathological examination confirmed synovial cyst. The patient's symptoms resolved immediately after surgery except for a mild dysesthesia of the right leg. We report herein a rare case of foraminal synovial cyst associated with AS accompanying posterior element fracture with a review of literature.

Bilateral Thoracic Ganglion Cyst : A Rare Case Report

Kazanci, Burak,Tehli, Ozkan,Turkoglu, Erhan,Guclu, Bulent The Korean Neurosurgical Society 2013 Journal of Korean neurosurgical society Vol.53 No.5

Ganglion cysts usually arise from the tissues around the facet joints. It is usually associated with degenerative cahanges in facet joints. Bilateral thoracic ganglion cysts are very rare and there is no previous case that located in bilateral intervertebral foramen compressing the L1 nerve root associated with severe radiculopathy. We report a 53 years old woman who presented with bilateral groin pain and severe numbness. Magnetic resonance imaging revealed bilateral cystic mass in the intervertebral foramen between 12th thoracal and 1st lumbar vertebrae. The cystic lesions were removed after bilateral exposure of Th12-L1 foramens. The result of hystopathology confirmed the diagnosis as ganglion cyst. The ganglion cyst may compromise lumbar dorsal ganglion when it located in the intervertebral foramen. The surgeon should keep this rare entity in their mind for differential diagnosis.