title: Transoral surgical approach for treatment of symptomatic atlantoaxial cervical synovial cysts.
abstract: OBJECTIVE
  Synovial cysts are relatively common in the lumbar spine and very uncommon     in the cervical spine. Several case reports and a few small series have been     reported in the literature over the past four decades. There are two distinct     cervical spine synovial cyst categories: atlantoaxial and the subaxial cervical     spine. The surgical treatments are very different.
  
  
  METHODS
  We     report eleven patients undergoing transoral resection and posterior fusion for     histologically confirmed symptomatic atlantoaxial synovial cysts. This     represents a retrospective review over 18 years. The authors analyzed the     literature of patients who underwent surgical treatment for symptomatic     atlantoaxial synovial cysts.
  
  
  RESULTS
  There were four male and seven female     patients with a mean age of 76 years (range 54-84 years). All patients presented     with cervical myelopathy. Patients were neurologically assessed pre- and     postoperatively and outcome reported using the Modified Rankin Outcome score.     Mean follow-up period was 22 months (range 6-120 months). Ten of the eleven     patients had improvement in their postoperative assessment and one patient     remained unchanged.
  
  
  CONCLUSIONS
  Myelopathy is the presenting symptom in the vast     majority of these patients. Surgical resection and decompression of the neural     structures can be an effective treatment for symptomatic atlantoaxial synovial     cysts.
authors.affiliation: Mayo Clinic Arizona, Neurological Surgery, Phoenix/AZ, USA. lyons.mark2@mayo.edu
authors.forename: Mark K
authors.initials: MK
authors.lastname: Lyons
authors.forename: Barry
authors.initials: B
authors.lastname: Birch
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001268:Atlanto-Axial Joint / Q000473:pathology / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000601:surgery; D012189:Retrospective Studies; D013117:Spinal Cord Compression / Q000473:pathology / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods*; D013581:Synovial Cyst / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome