A cyst is a small sac of tissue filled with fluid, pus, or other material. Cysts are generally benign, or non-cancerous. Synovial cysts occur in the joints of the spine and are considered to be rare. These cysts are most often found in the lumbar (low back) region of the spine, particularly in the facet joints at the L4-L5 level.
Since synovial cysts are often the result of age-related degeneration, or wear and tear, older people are the most likely age group to be diagnosed with the condition. These patients often have other degenerative conditions of the spine including arthritis and disc disease. Synovial cysts may also affect people with the autoimmune disease RA, or rheumatoid arthritis.
Symptoms
Sometimes these cysts cause no symptoms or problems at all. However, if the cyst is large enough, it can put pressure on the spine and nearby nerves. Common symptoms include low back pain and difficulty walking or standing. The pain may be relieved when sitting. Other symptoms include diminished reflexes, sciatica, or numbness, tingling, cramping, and pain in the leg or buttocks. As the cyst grows, it may cause stenosis (narrowing) of the spinal canal.
Diagnosis
Synovial cysts are best diagnosed through MRI imaging. X-rays may be used to rule out other conditions. The cyst will appear near the facet joint as a bubble-like growth. A CT scan can help determine the density of the cyst.
Treatment Options
Treatments may depend on the size of the cyst. Conservative treatments include rest, anti-inflammatory pain medications, epidural steroid injections, or draining the fluid in the sac. However, the cyst may fill up again eventually if the sac is not removed. Physical therapy may be recommended. Therapeutic exercises can strengthen the muscles around the affected joint. Heat and ice therapy, ultrasound, and electrical stimulation can reduce pain and inflammation.
When conservative treatments have not been successful, surgery may be recommended. Surgical treatment involves removing the cyst to relieve pressure on the spinal cord and nerve roots. Sometimes joint fusion is necessary to prevent the cyst from recurring. This stops the movement at that level of the spine. Fortunately, most cases do not require surgery.
Atlanta Brain and Spine Care
The spine specialists at Atlanta Brain and Spine Care are experts in the diagnosis and treatment of synovial cysts of the spine. There are five convenient metro Atlanta locations to meet the needs of our patients. Contact us to schedule a consultation with one of our physicians.
