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Should Spinal Cysts Be Removed?
Should Spinal Cysts Be Removed?

A spinal cyst is a fluid-filled sac that can develop within the spinal cord.  If the cyst is small, the patient may not experience any symptoms.  As the cyst grows larger, pain, cramping, and numbness may develop.  Cysts are benign, or non-cancerous, so they do not have to be removed unless they are causing a problem.

Types of Spinal Cysts

Synovial cysts are the most common spinal cysts.  They may develop within the facet joints as the cartilage wears away during the aging process.  People over age 50 are more at risk for synovial cysts.  These patients may have arthritis and other degenerative spinal conditions.

Another type of spinal cyst is the arachnoid cyst, which can occur between the brain or spinal cord and the arachnoid membrane.  Individuals can be born with this type of cyst.  A third type of spinal cyst is a Tarlov cyst.  They are usually found near the bottom of the spine and can surround a nerve root coming from the spine.  Tarlov cysts are often asymptomatic.

Symptoms

The level of symptoms will depend on the size and location of the cyst.  If the cyst presses on a nerve, the patient may feel back pain, have diminished reflexes, or difficulty standing or walking.  If the cyst is located in the low back, there may be weakness, tingling, or numbness in the buttocks, legs, or feet.

Diagnostic Tests

Many cysts are identified through an MRI.  An x-ray or CT scan may also be ordered to rule out other spinal conditions.  It is important to identify any instability in the spine before some treatments are undertaken.

Treatments

The good news for the patient is that surgery is not always necessary.  Conservative treatments are usually tried first.  If there are no symptoms, the physician may decide to just monitor the cyst regularly.  Patients experiencing mild or moderate pain may benefit from being treated with anti-inflammatory medications or epidural steroid injections to reduce inflammation.  Sometimes the cyst may be drained, although there is no guarantee it won’t fill up again with fluid eventually.

Cysts that have not responded well to conservative treatments may require surgical removal.  Patients with significant pain or neurological symptoms are among those needing surgical intervention.  Removing the cyst eliminates pressure on the nerve roots and provides more room for the spinal cord.  Minimally invasive surgery is often an option.  Advantages of minimally invasive surgery include smaller incisions, less post-operative pain, and a faster recovery.

Next Steps

The physicians at Atlanta Brain and Spine Care are experts in the diagnosis and treatment of spinal cysts.  Our team of neurosurgeons offer patients access to some of the world’s most advanced treatments and procedures.  Contact us today to schedule an appointment.

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