Progressive Neurological Deficit Secondary to Lumbar Facet Synovial Cysts: Two Case Studies and a Literature Review

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Abstract

This article describes two case studies involving lumbar facet joint synovial cyst causing acute sciatica and progressive neurological deficit. The cases involve women, 57 and 69 years old, respectively. The first patient was presented with left buttock and lower leg pain, numbness and paresthesia, while the second one had progressive right lower leg pain for 3 months. Magnetic resonance imaging revealed a high intensity cystic lesion arising from the facet joint, subsequently causing spinal stenosis and exiting nerve root compression. Surgery was performed, including laminectomy and cyst excision. Microscopic observation confirmed synovial cysts. Following operation, clinical symptoms of the patients improved significantly with no neurological sequelae. Based on our experience with these two patients treated by open surgery in our hospital, this study attempted to more thoroughly elucidate the significance and treatment outcome of a surgically treated lumbar synovial cyst. Moreover, relevant literature was reviewed, with a focus on their clinical presentations, imaging findings, and postoperative surgical outcomes.
Original languageEnglish
Pages (from-to)132-137
Number of pages6
JournalFormosan Journal of Musculoskeletal Disorders
Volume5
Issue number3
DOIs
Publication statusPublished - 2014

Fingerprint

Synovial Cyst
Zygapophyseal Joint
Leg
Sciatica
Pain
Spinal Stenosis
Buttocks
Radiculopathy
Laminectomy
Hypesthesia
Paresthesia
Cysts
Magnetic Resonance Imaging

Keywords

  • synovial cyst
  • neurological deficits
  • lumbar facet

Cite this

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title = "Progressive Neurological Deficit Secondary to Lumbar Facet Synovial Cysts: Two Case Studies and a Literature Review",
abstract = "This article describes two case studies involving lumbar facet joint synovial cyst causing acute sciatica and progressive neurological deficit. The cases involve women, 57 and 69 years old, respectively. The first patient was presented with left buttock and lower leg pain, numbness and paresthesia, while the second one had progressive right lower leg pain for 3 months. Magnetic resonance imaging revealed a high intensity cystic lesion arising from the facet joint, subsequently causing spinal stenosis and exiting nerve root compression. Surgery was performed, including laminectomy and cyst excision. Microscopic observation confirmed synovial cysts. Following operation, clinical symptoms of the patients improved significantly with no neurological sequelae. Based on our experience with these two patients treated by open surgery in our hospital, this study attempted to more thoroughly elucidate the significance and treatment outcome of a surgically treated lumbar synovial cyst. Moreover, relevant literature was reviewed, with a focus on their clinical presentations, imaging findings, and postoperative surgical outcomes.",
keywords = "synovial cyst, neurological deficits, lumbar facet",
author = "Chin-Chean Wong and Yang-Hwei Tsuang and Chang-Jung Chiang and Wei-Pin Ho",
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AU - Wong, Chin-Chean

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AU - Ho, Wei-Pin

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N2 - This article describes two case studies involving lumbar facet joint synovial cyst causing acute sciatica and progressive neurological deficit. The cases involve women, 57 and 69 years old, respectively. The first patient was presented with left buttock and lower leg pain, numbness and paresthesia, while the second one had progressive right lower leg pain for 3 months. Magnetic resonance imaging revealed a high intensity cystic lesion arising from the facet joint, subsequently causing spinal stenosis and exiting nerve root compression. Surgery was performed, including laminectomy and cyst excision. Microscopic observation confirmed synovial cysts. Following operation, clinical symptoms of the patients improved significantly with no neurological sequelae. Based on our experience with these two patients treated by open surgery in our hospital, this study attempted to more thoroughly elucidate the significance and treatment outcome of a surgically treated lumbar synovial cyst. Moreover, relevant literature was reviewed, with a focus on their clinical presentations, imaging findings, and postoperative surgical outcomes.

AB - This article describes two case studies involving lumbar facet joint synovial cyst causing acute sciatica and progressive neurological deficit. The cases involve women, 57 and 69 years old, respectively. The first patient was presented with left buttock and lower leg pain, numbness and paresthesia, while the second one had progressive right lower leg pain for 3 months. Magnetic resonance imaging revealed a high intensity cystic lesion arising from the facet joint, subsequently causing spinal stenosis and exiting nerve root compression. Surgery was performed, including laminectomy and cyst excision. Microscopic observation confirmed synovial cysts. Following operation, clinical symptoms of the patients improved significantly with no neurological sequelae. Based on our experience with these two patients treated by open surgery in our hospital, this study attempted to more thoroughly elucidate the significance and treatment outcome of a surgically treated lumbar synovial cyst. Moreover, relevant literature was reviewed, with a focus on their clinical presentations, imaging findings, and postoperative surgical outcomes.

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