From the Research
A spinal synovial cyst is a fluid-filled sac that develops along the spine, typically arising from the facet joints where vertebrae connect, and can cause symptoms such as back pain, radiculopathy, and neurological deficits when it compresses nearby nerve roots or the spinal cord. These cysts form when the synovial lining of these joints produces excess fluid that collects and creates a pouch-like structure. Spinal synovial cysts most commonly occur in the lumbar spine (lower back), particularly at the L4-L5 level, and are more prevalent in older adults due to age-related degeneration of the spine, as reported in a study published in the Journal of Neurosurgery 1. They often develop as a result of arthritis or instability in the facet joints.
Causes and Symptoms
While many spinal synovial cysts are asymptomatic and discovered incidentally during imaging for other conditions, they can cause symptoms when they compress nearby nerve roots or the spinal cord. Common symptoms include:
- Localized back pain
- Radiating pain into the legs (sciatica)
- Numbness
- Tingling
- Weakness in the affected area A study published in the Journal of Spinal Disorders & Techniques found that synovial cysts of the lumbar spine contribute significantly to narrowing of the spinal canal and lateral thecal sac and nerve root compression 2.
Treatment Options
Treatment options range from conservative approaches like rest, physical therapy, and anti-inflammatory medications to more invasive procedures such as steroid injections or surgical removal if the cyst causes significant pain or neurological symptoms that don't respond to conservative treatment. Percutaneous intra-articular steroid treatment without cyst rupture is a safe treatment for symptomatic spinal synovial cysts and eliminates the need for surgery in a substantial number of patients, as suggested by a study published in the Journal of Neurointerventional Surgery 3. However, surgical decompression with or without fusion may be necessary in cases of significant neurologic deficit, motor weakness, back pain, multiple synovial cysts, or spondylolisthesis, as reported in a study published in World Neurosurgery 1.