Atypical presentation of a cervical synovial cyst.
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.



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.



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.
Orthopedic and Traumatology Department, Centro Hospitalar São João, Alameda Professor Hernâni Monteiro, Porto, 4200-319, Portugal. Daniela_linhares@sapo.pt.|MEDCIDS, Faculty of Medicine of University of Porto, Porto, Portugal. Daniela_linhares@sapo.pt.
Daniela
0000-0001-7398-0626
D
Linhares
Orthopedic and Traumatology Department, Centro Hospitalar São João, Alameda Professor Hernâni Monteiro, Porto, 4200-319, Portugal.
João
J
Lobo
Orthopedic and Traumatology Department, Centro Hospitalar São João, Alameda Professor Hernâni Monteiro, Porto, 4200-319, Portugal.|Faculty of Medicine of University of Porto, Porto, Portugal.
Rui
R
Pinto
Orthopedic and Traumatology Department, Centro Hospitalar São João, Alameda Professor Hernâni Monteiro, Porto, 4200-319, Portugal.|Faculty of Medicine of University of Porto, Porto, Portugal.
Nuno
N
Neves
D000368:Aged; D019299:Decompression, Surgical; D006801:Humans; D007593:Joint Instability / Q000209:etiology* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D018908:Muscle Weakness / Q000209:etiology*; D009408:Nerve Compression Syndromes / Q000209:etiology*; D010292:Paresthesia / Q000209:etiology*; D011843:Radiculopathy / Q000601:surgery; D013123:Spinal Fusion / Q000379:methods; D013168:Spondylolisthesis / Q000601:surgery; D013581:Synovial Cyst / Q000150:complications* / Q000601:surgery; D016896:Treatment Outcome
Cervical spine; Radiculopathy; Spine surgery; Synovial cyst