Spinal synovial cyst presenting with radiculopathy

Abstract

Synovial cyst (SC) is one of the relatively rarer spinal pathology which can lead to radicular feature. The most common differential diagnosis is herniation of intervertebral disc (HID).

A 34 year-old male patient presented to orthopedic surgeon with the history of right thigh pain on and off. The case was then referred to us. On examination, he had mild hypoesthesia over fronto lateral aspect of right thigh and knee jerk wasslightly diminished. Repeat magnetic resonance imaging (MRI) of lumbosacral spine was done as previous image quality was poor.

New MRI suggested cystic lesion at L2-3 on right side suggesting most likely synovial cyst.

With midline incision, right hemilaminotomy was done and thecal sac and nerve root was exposed. When thecal sac and nerve root was retracted, cystic lesion was very clearly seen arising from facet joint. Complete excision was done and sent for histological evaluation which showed features of synovial cyst.

Post operatively, thigh pain disappeared and patient went have to normal work after 1 month of surgery.

The main purpose of this article is to emphasize that synovial cyst is one of the possible, though rare, etiology of radiculopathy. Though it occurs in older age group it can be found in younger people also as in our case. Surgical exploration and radical resection is the way to cure it.