Intraspinal lumbar synovial cysts: diagnosis and surgical management

Abstract

Background: Lumbar synovial cysts are a common association of facet joint degenerative disease. However, it is relatively rare for these cysts to cause symptoms of radiculopathy and nerve root compression.

Patients and methods: We report a series of eight cases which were treated over a period of 20 months. There were five female and three male patients with a mean age of 66 years, and an average follow-up of seventeen months. All patients had pre-operative flexion/extension radiographs and MRI scans. Two patients had failed non-surgical treatment, two were associated with a Grade 1 spondylolisthesis, and all were associated with facet joint arthropathy. There were five cases occurring at L4/5 and three at L5/S1.

Results: All patients underwent identical procedures, which involved exploration, hemi-laminotomy, flavectomy and minimal facet joint excision. No patient required posterior lumbar interbody fusion and at follow-up five patients had excellent and three had good results.