Synovial cyst of the thoracic spine causing myelopathy.
METHODS
Pre- and postoperative follow-up of a patient with progressive myelopathy caused by a thoracic synovial cyst developing within 6 months.


OBJECTIVE
To present the natural history of a developing thoracic synovial cyst and to highlight this unusual case.


BACKGROUND
Thoracic synovial cysts are a rare finding and can produce myelopathy from spinal cord compression. The patient presented with progressing spasticity and sensory loss of both legs. Hereditary motor-sensory neuropathy was suspected and excluded by a molecular genetic examination. The cause of deterioration was finally found in an MRI of the thoracic spine revealing the rapid growth of a synovial cyst that had been detected in a previously performed MRI 6 months earlier.


METHODS
Clinical and MRI details are presented documenting the natural history and development of a thoracic synovial cyst causing myelopathy.


RESULTS
The thoracic synovial cyst was successfully decompressed. Stabilization and fusion were not performed. The myelopathy resolved after surgery and the patient stays well in the 6-months follow-up.


CONCLUSIONS
Although thoracic synovial cysts are a rare finding, they have to be considered as a source for progressive myelopathy. If an MRI of the spine does not reveal any pathologies, it should be repeated even after a short period of time if the patient's condition deteriorates, continuously to detect newly developed findings.
Merkle
Martin
M
Department of Neurosurgery, Eberhard-Karls University of Tuebingen, Tuebingen, Germany. martin.merkle@med.uni-tuebingen.de
Psaras
Tsambika
T
Tatagiba
Marcos
M
Danz
Sören
S
Schmidt
Fernando
F
D000368:Aged; D002574:Cervical Vertebrae / Q000473:pathology; D019299:Decompression, Surgical; D018450:Disease Progression; D006801:Humans; D007796:Laminectomy; D008279:Magnetic Resonance Imaging; D008297:Male; D013130:Spinal Stenosis / Q000209:etiology* / Q000473:pathology* / Q000601:surgery; D013581:Synovial Cyst / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D013904:Thoracic Vertebrae / Q000473:pathology* / Q000601:surgery