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Case Reports
. 2022 Oct 15;14(10):7607-7611.
eCollection 2022.

A rare case of facet joint synovial cyst connected to the intrathecal space: a case report

Joo Yong Lee  1 , Hyeon Tae Kim  1 , Ji Young Park  1 , Young Duck Shin  1
Affiliations
Case Reports

A rare case of facet joint synovial cyst connected to the intrathecal space: a case report

Joo Yong Lee et al. Am J Transl Res. .

Abstract

Unexpected injection of local anesthetics into the intrathecal space can cause adverse effects, such as hypotension, shortness of breath, bradycardia, numbness or weakness, nausea and vomiting and serious complications, such as respiratory arrest, loss of consciousness and cardiac arrest. In this study, we report a case of a 68-year-old woman with a facet joint synovial cyst connected to the intrathecal space. The patient's clinical symptoms and radiological findings were consistent with those of a facet joint synovial cyst; however, during facet joint synovial cyst aspiration, it was found that the cyst was connected to the intrathecal space. Our experience shows that during the procedure of facet joint injection and facet joint synovial cyst aspiration, local anesthetics may be inadvertently injected intrathecally. Although this is highly uncommon, it can lead to serious side effects, such as total spinal anesthesia. Therefore, we present this case, along with a brief literature review.

Keywords: Local anesthetics; complications; facet joint synovial cyst; injections; intrathecal.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Patient’s magnetic resonance images (MRI). (A) Axial and (B) sagittal MRI images of the lumbar spine demonstrating an intraspinal facet joint cyst located in the right L5/S1 facet region.
Figure 2
Figure 2
Anterior-posterior fluoroscopic images. A. An intraspinal facet joint cyst filled with dye was seen as a circular shape at the L5/S1 level. B. An intraspinal facet joint cyst filled with dye was seen as water droplet-shaped at the L5/S1 level.
Figure 3
Figure 3
Fluoroscopic images of contrast medium moving towards the cephalad in the intrathecal space. A-C. Lateral view. Fluoroscopic images were taken at intervals of about 1 second and the images were arranged in chronological order. D. Anterior-posterior view. The shadow of the contrast medium that has spread to the L3 body level is confirmed.
See this image and copyright information in PMC

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