Spinal synovial cyst

Case contributed by Andrei Tsoriev
Diagnosis certain

Presentation

Presents with a chronic back pain.

Patient Data

Age: 55
Gender: Female
mri

Lumbarization of S1.

L4 degenerative tiny antelisthesis. 

Cystic mass located in vertebral canal associated with a left L4-L5 facet joint, near to left superior articular L5 processus, compressing dural sac and ipsilateral L4 nerve root. Vivid peripheral enhancement due to inflammation processes.

Modic type 2 changes of the L5-S1 end plates.

Moderate spondylarthrosis in all segments, more prominent at the L4-L5 level.

Case Discussion

The incidence of spinal lumbar synovial cysts is thought to be less than 0.5% of the general symptomatic population.

They are commonly found at L4-5 level, the site of maximum mobility.

Synovial cysts have a resistance to conservative therapy and should be treated surgically.

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