title: Subaxial cervical synovial cysts: report of 35 histologically confirmed surgically treated cases and review of the literature.
abstract: METHODS
  Retrospective study
  
  
  OBJECTIVE
  The authors' aim of the present study is to report their experience with subaxial cervical synovial cysts hoping to provide further insight into these lesions including the presenting symptoms, possible mechanisms of cyst development associated with cervical level, surgical treatments and clinical outcomes.
  
  
  BACKGROUND
  Synovial cysts are relatively common in the lumbar spine and very uncommonly identified in the subaxial cervical spine. Several case reports and a few small series have been reported in the literature over the past four decades.
  
  
  METHODS
  The authors retrospectively reviewed the cases of 35 patients who underwent surgical treatment for histologically confirmed symptomatic subaxial cervical synovial cysts between 1993 and 2009. The presenting symptoms, age, sex, cervical level, operation, complications and outcomes were analyzed in this cohort. Preoperative and postoperative neurologic assessments were done by staff neurologists independent of the operating surgeon. This study was approved by the Mayo Clinic institutional review board.
  
  
  RESULTS
  Thirty-five patients underwent surgical treatment for their synovial cysts and follow-up for at least 12 months postoperatively. The mean follow-up time was 49 months (range, 12-134). There were no deaths associated with the surgery. There was one postoperative infection in a patient undergoing a decompressive laminectomy and posterior instrumented fusion. Patient outcomes were assessed using the Modified Rankin Score for 12 patients was 0, 17 patients was 1, 4 patients was 2, and 2 patients was 3.
  
  
  CONCLUSIONS
  This series of 35 patients with subaxial cervical synovial cysts surgically treated over a period of 17 years illustrates the relative rarity of these lesions. Magnetic resonance imaging is currently the optimal radiographic study to identify these lesions. Surgical resection can be an effective treatment.
authors.affiliation: Department of Neurological Surgery, Mayo Clinic, Phoenix, Arizona 85054, USA. lyons.mark2@mayo.edu
authors.forename: Mark K
authors.initials: MK
authors.lastname: Lyons
authors.forename: Barry D
authors.initials: BD
authors.lastname: Birch
authors.forename: William E
authors.initials: WE
authors.lastname: Krauss
authors.forename: Naresh P
authors.initials: NP
authors.lastname: Patel
authors.forename: Eric W
authors.initials: EW
authors.lastname: Nottmeier
authors.forename: Orland K
authors.initials: OK
authors.lastname: Boucher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002574:Cervical Vertebrae / Q000473:pathology* / Q000601:surgery*; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000379:methods / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000473:pathology* / Q000601:surgery*; D013581:Synovial Cyst / Q000473:pathology* / Q000601:surgery*