Synovial cyst

What is it?

A synovial cyst is a fluid-filled sac that develops in the spine, typically in the lumbar region. It occurs due to the degeneration of the facet joints, part of the vertebrae that provide spinal flexibility and movement. This cyst is frequently associated with other degenerative spinal conditions such as spinal stenosis or osteoarthritis.

Symptoms

The symptoms of synovial cysts can vary depending on the cyst’s size and location. Common symptoms include:

  • Back Pain: This is usually the main symptom, and it can feel like a dull, aching sensation.
  • Radicular Symptoms: When the cyst compresses a nerve root, it can cause sciatica-like symptoms, such as pain, numbness, tingling, or weakness that radiates down the legs.
  • Limited Mobility: The affected person may experience stiffness and a decreased range of motion in their spine.

Some synovial cysts may remain asymptomatic and only be discovered incidentally during imaging for unrelated reasons.

Diagnosis

The diagnosis typically involves the following steps:

  • Medical History and Physical Examination: A doctor assesses the person’s symptoms, physical mobility, and nerve function.
  • Imaging Tests: MRI Scans, CT Scans, X-rays

Treatment

The treatment of synovial cysts varies and can range from conservative management to surgical intervention:

  • Conservative Treatments: These include physical therapy, anti-inflammatory medications, and possibly corticosteroid injections to alleviate inflammation and pain.
  • Activity Modification: Advised to reduce activities that worsen symptoms.
  • Epidural Steroid Injections: These injections can offer temporary pain relief.
  • Surgical Treatment: Surgery may be considered when conservative treatments are ineffective, and symptoms are severe. This typically involves decompression surgery, which may include removing the cyst and part of the facet joint. In some cases, spinal fusion might be necessary to maintain spinal stability.

Most people with synovial cysts respond well to conservative treatments, especially when symptoms are mild.