Top

European Spine Journal

Published in:

01-09-2017 | Grand Rounds

Atypical presentation of a cervical synovial cyst

Authors: Daniela Linhares, João Lobo, Rui Pinto, Nuno Neves

Published in: European Spine Journal | Issue 9/2017

Abstract

Introduction

https://static-content.springer.com/image/art%3A10.1007%2Fs00586-017-4947-4/MediaObjects/586_2017_4947_Figa_HTML.jpg

Synovial cysts of the cervical spine are rare. These lesions have been associated with other spinal conditions as osteoarthritis, spondylolisthesis, and disc degeneration, with authors postulating a possible link with segmental spinal instability. This study aims to describe an atypically presenting case of a cervical synovial cyst.

Case report

A 65-year-old man presented with complaints of cervical radicular pain (VAS of 7) that evolved with development of paresthesia and muscular weakness, compatible with C8 right compression. This symptomatology had an odd pattern with total regression of symptoms when lying supine or upon extreme efforts, leading to a delayed referral to MRI. A C7–T1 synovial cyst was identified, compressing the C8 nerve root. The patient was submitted to decompression and instrumented fusion of the affected level and showed total regression of symptoms.

Conclusions

Although rare, cervical synovial cysts are associated with a significant impairment in patients’ daily activities. The atypical pattern of symptoms described in this case may be associated with the fluid content of the cyst, with postural changes causing different degrees of root compression. Most authors agree on a surgical option, but the need for associated fusion is still under debate.

Lunardi P, Acqui M, Ricci G, Agrillo A, Ferrante L (1999) Cervical synovial cysts: case report and review of the literature. Eur Spine J 8(3):232–237CrossRefPubMedPubMedCentral

Lyons MK, Birch BD, Krauss WE, Patel NP, Nottmeier EW, Boucher OK (2011) Subaxial cervical synovial cysts: report of 35 histologically confirmed surgically treated cases and review of the literature. Spine (Phila Pa 1976) 36(20):E1285–E1289. doi:10.1097/BRS.0b013e31820709a8 CrossRef

Boviatsis EJ, Staurinou LC, Kouyialis AT, Gavra MM, Stavrinou PC, Themistokleous M, Selviaridis P, Sakas DE (2008) Spinal synovial cysts: pathogenesis, diagnosis and surgical treatment in a series of seven cases and literature review. Eur Spine J 17(6):831–837. doi:10.1007/s00586-007-0563-z CrossRefPubMedPubMedCentral

Corredor JA, Quan G (2015) Cervical synovial cyst causing cervical radiculomyelopathy: case report and review of the literature. Glob Spine J 5(4):e34–e38. doi:10.1055/s-0034-1396758 CrossRef

Lopes NM, Aesse FF, Lopes DK (1992) Compression of thoracic nerve root by a facet joint synovial cyst: case report. Surg Neurol 38(5):338–340CrossRefPubMed

Colen CB, Rengachary S (2006) Spontaneous resolution of a cervical synovial cyst. Case illustration. J Neurosurg Spine 4(2):186. doi:10.3171/spi.2006.4.2.186 CrossRefPubMed

Dahuja A, Dahuja G, Kaur R (2015) Rare thoracolumbar facet synovial cyst presenting as paraparesis. Korean J Spine 12(3):193–195. doi:10.14245/kjs.2015.12.3.193 CrossRefPubMedPubMedCentral

Epstein NE, Baisden J (2012) The diagnosis and management of synovial cysts: efficacy of surgery versus cyst aspiration. Surg Neurol Int 3(Suppl 3):S157–S166. doi:10.4103/2152-7806.98576 CrossRefPubMedPubMedCentral

Nojiri H, Uta S, Sakuma Y (2009) Degenerative intraspinal cyst of the cervical spine. Orthop Rev (Pavia) 1(2):e17. doi:10.4081/or.2009.e17 CrossRef

10.

Tillich M, Trummer M, Lindbichler F, Flaschka G (2001) Symptomatic intraspinal synovial cysts of the lumbar spine: correlation of MR and surgical findings. Neuroradiology 43(12):1070–1075CrossRefPubMed

11.

Muir JJ, Pingree MJ, Moeschler SM (2012) Acute cauda equina syndrome secondary to a lumbar synovial cyst. Pain Phys 15(5):435–440

12.

Allen TL, Tatli Y, Lutz GE (2009) Fluoroscopic percutaneous lumbar zygapophyseal joint cyst rupture: a clinical outcome study. Spine J 9(5):387–395. doi:10.1016/j.spinee.2008.08.008 CrossRefPubMed

13.

Shima Y, Rothman SL, Yasura K, Takahashi S (2002) Degenerative intraspinal cyst of the cervical spine: case report and literature review. Spine (Phila Pa 1976) 27(1):E18–E22CrossRef

Title: Atypical presentation of a cervical synovial cyst
Authors: Daniela Linhares
João Lobo
Rui Pinto
Nuno Neves
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 9/2017
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-017-4947-4

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Atypical presentation of a cervical synovial cyst

Abstract

Introduction

Case report

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Case report

Conclusions

Please log in to get access to this content

Other articles of this Issue 9/2017

Trends analysis of surgical procedures for cervical degenerative disc disease and myelopathy in patients with tobacco use disorder

A finite element study of traditional Chinese cervical manipulation

Which salvage fixation technique is best for the failed initial screw fixation at the cervicothoracic junction? A biomechanical comparison study

Erratum to: The diagnosis and management of infection following instrumented spinal fusion

C4/5 foraminal stenosis predicts C5 palsy after expansive open-door laminoplasty

Reliability and validity of clinical tests to assess the anatomical integrity of the cervical spine in adults with neck pain and its associated disorders: Part 1—A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) Collaboration