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The Journal of Rheumatology Feb 2021
Topics: Humans; Synovial Cyst; Temporomandibular Joint
PubMed: 33526648
DOI: 10.3899/jrheum.200477 -
Neurology India 2022
Topics: Cauda Equina; Cauda Equina Syndrome; Humans; Lumbar Vertebrae; Lumbosacral Region; Synovial Cyst
PubMed: 36076689
DOI: 10.4103/0028-3886.355166 -
World Neurosurgery Jun 2019Isolated hypoglossal nerve palsy caused by an atlantooccipital synovial cyst is a rare lesion, with fewer than 5 cases reported in the literature. (Review)
Review
BACKGROUND
Isolated hypoglossal nerve palsy caused by an atlantooccipital synovial cyst is a rare lesion, with fewer than 5 cases reported in the literature.
CASE DESCRIPTION
Our patient presented with acute hypoglossal nerve dysfunction. Our differential included neoplasm, trauma, stroke, multiple sclerosis, or other inflammatory/infectious etiology. Imaging revealed a peripherally enhancing, extradural focus in the left premedullary cistern, most likely consistent with a synovial cyst.
CONCLUSIONS
A left suboccipital craniectomy was performed in the region of the left hypoglossal canal, in which a cystic structure was noted at the occipital condyle and C1 vertebral junction. The nerve was adequately decompressed via aspiration of the cyst. Postoperatively, the patient substantially improved. Although rare, synovial cysts must be included in the differential diagnosis of atlantooccipital lesions.
Topics: Aged; Atlanto-Occipital Joint; Humans; Hypoglossal Nerve Diseases; Magnetic Resonance Imaging; Male; Synovial Cyst
PubMed: 30922910
DOI: 10.1016/j.wneu.2019.03.159 -
World Neurosurgery Aug 2016Degenerative cystic lesions of atlantoaxial joints are rare and generally believed to be due to mechanical instability. There is currently no consensus on the management... (Review)
Review
BACKGROUND
Degenerative cystic lesions of atlantoaxial joints are rare and generally believed to be due to mechanical instability. There is currently no consensus on the management of such lesions in symptomatic and asymptomatic patients. Both conservative and surgical strategies have been described. Surgery may involve anterior or posterior approaches with and without decompression and instrumentation.
METHODS
We present a case report of a 45-year-old man who presented with new onset weakness and ataxia. Physical examination revealed decreased motor function in all extremities as well as positive Hoffman sign and ankle clonus bilaterally. An MRI of cervical spine showed a large atlantoaxial, T-2 hyperintense cystic lesion with cord compression and cord signal changes.
RESULTS
A C1 partial laminectomy was performed with resection of the cyst and C1-2 instrument fusion. Intra-operatively, the cystic lesion was found to be anatomically connected to the right C1-2 atlantoaxial joint with pathology showing fibroconnective tissue and chronic inflammatory changes. Post-operatively there were no complications and the patient was discharged to a rehabilitation facility. The patient was regaining gait and hand function by 3 months after surgery.
CONCLUSIONS
Atlantoaxial synovial cysts are rare and the optimal surgical approach has not been determined. We further conducted a literature review and found a total of 70 other cases of atlantoaxial synovial cysts reported to date in the literature. We attempt to analyze available data and evaluate anterior versus posterior approaches and the need for decompression, amount of cyst resection, and instrumentation.
Topics: Atlanto-Axial Joint; Humans; Laminectomy; Magnetic Resonance Imaging; Male; Middle Aged; PubMed; Synovial Cyst; Tomography Scanners, X-Ray Computed
PubMed: 27108023
DOI: 10.1016/j.wneu.2016.04.036 -
World Neurosurgery Nov 2023Synovial cysts of the spine are degenerative cystic lesions that can lead to severe symptoms secondary to compression of the spinal cord, individual nerve roots, and/or...
Synovial cysts of the spine are degenerative cystic lesions that can lead to severe symptoms secondary to compression of the spinal cord, individual nerve roots, and/or the cauda equina. Some believe the etiology of this entity is related to increased motion across the facet joint and instability. We report a case of a lumbar synovial cyst located at the same level as a previously inserted spinous process fusion device. This case illustrates that, unlike a transpedicular instrumented fusion where the risk of synovial cyst formation is zero, a spinal process fusion can still lead to synovial cyst formation likely due to persistent micromotion across that segment.
Topics: Humans; Lumbar Vertebrae; Laminectomy; Spinal Fusion; Decompression, Surgical; Synovial Cyst
PubMed: 37597664
DOI: 10.1016/j.wneu.2023.08.041 -
Journal of Neurosurgery. Spine Dec 2022Lumbar synovial cysts (LSCs) represent a relatively rare clinical pathology that may result in radiculopathy or neurogenic claudication. Because of the potential for... (Review)
Review
OBJECTIVE
Lumbar synovial cysts (LSCs) represent a relatively rare clinical pathology that may result in radiculopathy or neurogenic claudication. Because of the potential for recurrence of these cysts, some authors advocate for segmental fusion, as opposed to decompression alone, as a way to eliminate the risk for recurrence. The objective of this study was to create a predictive score for synovial cyst recurrence following decompression without fusion.
METHODS
A retrospective chart review was completed of all patients evaluated at a single center over 20 years who were found to have symptomatic LSCs requiring intervention. Only patients undergoing decompression without fusion were included in the analysis. Following this review, baseline characteristics were obtained as well as radiological information. A machine learning method (risk-calibrated supersparse linear integer model) was then used to create a risk stratification score to identify patients at high risk for symptomatic cyst recurrence requiring repeat surgical intervention. Following the creation of this model, a fivefold cross-validation was completed.
RESULTS
In total, 89 patients were identified who had complete radiological information. Of these 89 patients, 11 developed cyst recurrence requiring reoperation. The Lumbar Synovial Cyst Score was then created with an area under the curve of 0.83 and calibration error of 11.0%. Factors predictive of recurrence were found to include facet inclination angle > 45°, canal stenosis > 50%, T2 joint space hyperintensity, and presence of grade I spondylolisthesis. The probability of cyst recurrence ranged from < 5% for a score of 2 or less to > 88% for a score of 7.
CONCLUSIONS
The Lumbar Synovial Cyst Score model is a quick and accurate tool to assist in clinical decision-making in the treatment of LSCs.
Topics: Humans; Retrospective Studies; Synovial Cyst; Spondylolisthesis; Decompression, Surgical; Cysts; Lumbar Vertebrae; Treatment Outcome
PubMed: 35907198
DOI: 10.3171/2022.5.SPINE22504 -
British Journal of Neurosurgery Oct 2023Hemorrhage into a juxtafacet cyst is rare and cyst rupture with hemorrhagic extension into the epidural space is even less commonly seen. We describe the case of a... (Review)
Review
Hemorrhage into a juxtafacet cyst is rare and cyst rupture with hemorrhagic extension into the epidural space is even less commonly seen. We describe the case of a patient with a hemorrhagic synovial cyst with rupture associated to abundant bleeding in the epidural space. A 61-year-old man had a 5-month history of worsening low back pain radiating into the right leg with associated weakness and numbness. A magnetic resonance imaging scan showed the presence of a mild anterior spondylolisthesis of L5 on S1 with increased synovial fluid into both facet joints. A suspected synovial cyst of the right facet joint at level L5-S1, with signal characteristics consistent with hemorrhage was seen. Caudally, epidural blood was evident from S1 to S2 that involved spinal canal and right S1 and S2 foramens. These findings were confirmed at surgery.
Topics: Male; Humans; Middle Aged; Synovial Cyst; Rupture; Magnetic Resonance Imaging; Spondylolisthesis; Hemorrhage; Lumbar Vertebrae
PubMed: 33241949
DOI: 10.1080/02688697.2020.1849547 -
British Journal of Neurosurgery Dec 2014Synovial cysts of the cervical spine are extremely rare. They can therefore pose a diagnostic challenge. We present an unusual case of acute symptomatology secondary to...
Synovial cysts of the cervical spine are extremely rare. They can therefore pose a diagnostic challenge. We present an unusual case of acute symptomatology secondary to spontaneous haemorrhage into a cervical facet joint cyst.
Topics: Aged; Cervical Vertebrae; Female; Humans; Radiography; Synovial Cyst
PubMed: 24801806
DOI: 10.3109/02688697.2014.913782 -
Practical Neurology Oct 2020
Topics: Atlanto-Axial Joint; Humans; Paralysis; Synovial Cyst
PubMed: 32366594
DOI: 10.1136/practneurol-2020-002504 -
The Pan African Medical Journal 2019Synovial cyst of the proximal tibiofibular joint is a very rare condition, for which there is no consensus regarding treatment. Two macroscopic forms may be encountered:... (Review)
Review
Synovial cyst of the proximal tibiofibular joint is a very rare condition, for which there is no consensus regarding treatment. Two macroscopic forms may be encountered: extraneural cysts and intraneural cysts. We present the cases of two patients who had synovial cysts of proximal tibiofibular joint that caused peroneal nerve palsy. We discussed the special features of synovial cysts and reviewed the literature. We considered the best treatment of synovial cysts originating from proximal tibiofibular joint and causing peroneal nerve palsy to be a total surgical removal as soon as possible after the diagnosis is made. However, follow-up is needed because recurrence is possible. It should be kept in mind that despite surgical treatment the neurological symptoms may not recover.
Topics: Adult; Female; Humans; Knee Joint; Male; Peroneal Neuropathies; Synovial Cyst
PubMed: 31934256
DOI: 10.11604/pamj.2019.34.115.18339