Synovial cysts are fluid filled sacs that can develop on the spine. They most often affect the facet joints of the lumbar (lower) spine. These cysts are relatively uncommon and are not cancerous. Individuals may have a synovial cyst for years without experiencing any symptoms.
Who is at risk?
People over the age of 50 are more at risk for developing synovial cysts. This may be a result of the aging process, as the joints wear down over a period of years. These patients may have other degenerative spinal conditions including arthritis or lumbar degenerative disc disease.
What are common symptoms caused by synovial cysts?
Small synovial cysts may go totally unnoticed. However, as the cysts increase in size, they may cause pain by pressing on nerves. Symptoms will vary, depending on the size and location of the cyst. Common symptoms include the following:
- pain or discomfort in the low back
- pain, numbness, or tingling in the legs or buttocks, such as sciatica
- difficulty standing or walking
- weakness in one or both legs
- diminished reflexes
What diagnostic tests are used?
Synovial cysts are usually found through an MRI (magnetic resonance imaging). The growth will clearly appear near a facet joint. The doctor may also recommend an x-ray, ultrasound, or CT scan. These diagnostic tests help rule out other possible causes of the patient’s symptoms.
Many synovial cysts will resolve on their own with conservative, non-operative treatments including rest, anti-inflammatory medications, or interventional pain management (steroidal injections). Occasionally, physical therapy may be recommended. Sometimes a physician will feel that draining the cyst is necessary. All of these measures may provide symptomatic relief of symptoms. Unfortunately, synovial cysts can sometimes reform or fill up with fluid again causing a renewal of symptoms.
Neurosurgeons can use several minimally invasive spine surgery techniques to treat synovial cysts that continue to cause pain or impair movement. These surgeries are generally used to treat cysts that have not responded well to more conservative treatments. Surgical removal of the cyst eliminates pressure on the nerve roots and provides more room for the spinal cord. Minimally invasive techniques offer several advantages over traditional surgeries including smaller incisions, less post-operative pain, and faster recoveries.
When to seek treatment
Patients who are experiencing unexplained low back pain, sciatica, leg pain, weakness, and difficulty walking or standing should be evaluated by a physician. Diagnostic testing should be done to determine whether the patient has a synovial cyst or another condition that is causing the symptoms. The neurosurgeons at Atlanta Brain and Spine Care are experienced in diagnosing and successfully treating synovial cysts.