[Spinal sinovial cysts: Surgical treatment and clinical outcomes in a series of 18 cases].
OBJECTIVE
A series of 18 patients with symptomatic synovial cysts was analysed from May 2009 to November 2013. Different approaches were performed for their removal.


METHODS
The study included 18 patients, 8 men and 10 women, aged between 50 and 77 years. An analysis was made of the variables including age, gender, symptoms, imaging studies, histopathology, surgery, follow-up, complications, and clinical outcome.


RESULTS
An articular synovial cyst was diagnosed in 17 cases, and a ganglion in one cases. The most common symptom was back pain with radiculopathy (94%). Motor deficits occurred in 4 cases (22%), and 1 case (5%) presented with urinary incontinence. The most common level was L4- L5 (67%), with one atypical case observed in the D12 -L1 location. Hemi-laminectomy was performed in 14 cases, with 9 of them having an interspinous spacer (ISP) device inserted. A laminectomy with a fusion procedure was performed in 3 patients and 1 patient had a bilateral decompression using a unilateral approach. The patients were followed-up for between 6 months to 2 years.


CONCLUSIONS
Synovial cysts are a cause of radiculopathy/neurogenic claudication. Spinal cysts are commonly found at the L4-L5 level. MRI is the tool of choice for diagnosis. The most common symptom was back pain with radiculopathy. Synovial cysts resistant to conservative therapy should be treated surgically. In our series, surgical resection of symptomatic juxtafacet cysts showed a good clinical outcome, but the optimal approach for patients with juxtafacet cysts remains unclear.
Servicio de Neurocirugía, Hospital Universitario La Paz, Madrid, España. Electronic address: Beatrizmf25@gmail.com.
Beatriz
B
Mansilla
Servicio de Neurocirugía, Hospital Universitario La Paz, Madrid, España.
Alberto
A
Isla
Servicio de Neurocirugía, Hospital Universitario La Paz, Madrid, España.
Carlos
C
Pérez-López
Servicio de Neurocirugía, Hospital Universitario La Paz, Madrid, España.
María
M
Román-de Aragón
Servicio de Neurocirugía, Hospital Universitario La Paz, Madrid, España.
Jorge
J
Zamorano
Servicio de Neurocirugía, Hospital Universitario La Paz, Madrid, España.
Javier
J
Giner
D000368:Aged; D001416:Back Pain / Q000209:etiology; D019299:Decompression, Surgical; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008866:Microsurgery / Q000379:methods; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D013122:Spinal Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013126:Spinal Nerve Roots / Q000473:pathology; D013581:Synovial Cyst / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
Abordaje; Approach; Articular process; Faceta articular; Juxtafacet cyst; Quistes articulares; Sinovial; Synovial