BACKGROUND: Spinal synovial cysts are a known cause of back pain and radiculopathy. With the advent of high-resolution imaging techniques, synovial cysts are increasingly diagnosed. There are a variety of treatment options for these lesions. METHODS: A systematic literature review of published articles reporting outcomes after nonsurgical and surgical management of spinal synovial cysts was performed. RESULTS: There were 51 published studies regarding the treatment of synovial cysts identified. Treatment modalities include observation, steroid injections, percutaneous cyst aspiration, hemilaminectomy or bilateral laminectomy with and without instrumented fusion, and minimally invasive cyst excision. CONCLUSIONS: Based on review of the treatment modalities and outcomes, recommendations for the management of patients with synovial cysts are proposed. Observation can be considered in cases where there is no intractable pain. High-risk surgical patients with intractable pain may consider corticosteroid injection or percutaneous cyst aspiration; however, the failure rate of such a procedure approaches 50%. Patients with intractable pain are candidates for surgical resection of the symptomatic cyst. In cases of significant neurologic deficit, motor weakness, back pain, multiple synovial cysts, or spondylolisthesis, bilateral laminectomy and instrumented fusion may offer the best long-term outcome.
BACKGROUND: Spinal synovial cysts are a known cause of back pain and radiculopathy. With the advent of high-resolution imaging techniques, synovial cysts are increasingly diagnosed. There are a variety of treatment options for these lesions. METHODS: A systematic literature review of published articles reporting outcomes after nonsurgical and surgical management of spinal synovial cysts was performed. RESULTS: There were 51 published studies regarding the treatment of synovial cysts identified. Treatment modalities include observation, steroid injections, percutaneous cyst aspiration, hemilaminectomy or bilateral laminectomy with and without instrumented fusion, and minimally invasive cyst excision. CONCLUSIONS: Based on review of the treatment modalities and outcomes, recommendations for the management of patients with synovial cysts are proposed. Observation can be considered in cases where there is no intractable pain. High-risk surgical patients with intractable pain may consider corticosteroid injection or percutaneous cyst aspiration; however, the failure rate of such a procedure approaches 50%. Patients with intractable pain are candidates for surgical resection of the symptomatic cyst. In cases of significant neurologic deficit, motor weakness, back pain, multiple synovial cysts, or spondylolisthesis, bilateral laminectomy and instrumented fusion may offer the best long-term outcome.
Authors: Ambrose J Huang; Stijn A Bos; Martin Torriani; F Joseph Simeone; Connie Y Chang; Stuart R Pomerantz; Miriam A Bredella Journal: Skeletal Radiol Date: 2016-10-22 Impact factor: 2.199
Authors: José Antonio Soriano Sánchez; Kai Uwe Lewandrowski; José Alfonso Franco Jímenez; Manuel Eduardo Soto Garcia; Sergio Soriano Solís; Manuel Rodríguez García; Oscar Sanchéz Escandón; José Alberto Israel Romero Rangel Journal: Int J Spine Surg Date: 2021-09-22
Authors: Bruno Splavski; Ante Rotim; Ivan Brumini; Ivan Koprek; Domagoj Gajski; Boris Božić; Krešimir Rotim Journal: Acta Clin Croat Date: 2019-09 Impact factor: 0.780