Synovial Intraspinal Cysts
The synovium is a fluid-producing layer of tissue around certain joints in the body, including the spine, and is present in order to lubricate these joints for easier movement. Infection of the synovium or degeneration of the fluid-filled sacs can be a cause of back pain or joint pain themselves but the presence of synovial cysts in the spine is usually a sign of prior spinal degeneration and joints rubbing together. Cysts occur where a small amount of the synovial fluid escapes into the joint capsule but remains inside the fluid-sac, creating a protrusion. Where this protruding synovial cyst becomes large it can narrow the spinal canal and put pressure on the spinal nerves, thus requiring treatment for pain relief and possible back surgery to drain the cyst.
Symptoms of Back Cysts
In most cases, as the cysts are not highly pressurised, even quite large synovial cysts remain unproblematic. For an unfortunate few, synovial cysts’ symptoms include neurological deficits, and possible cauda equina syndrome with loss of bladder or bowel control. Leaning forward can sometimes relieve the pressure caused by synovial cysts, particularly in older patients with radiating pain from the lumbar spine down the legs, and this may help identify the cause of the pain.
Diagnosing Spinal Cysts
Diagnosing synovial cysts will usually involve the use of X-Rays to assess joint degeneration, and possibly MRI scans to show soft-tissue injuries. X-Rays can also identify spinal instability from spondylolisthesis, facet joint degeneration, or other condition. Treatment for synovial cysts and spinal stenosis will depend on the underlying issue as simply removing the cyst from an unstable spine without correcting the instability could lead to a recurrence of symptoms as the cyst returns. Asymptomatic cysts do not usually warrant treatment and mild symptoms may be manageable by limiting uncomfortable activities or by using analgesics, injections, physical therapy, chiropractic treatment, or other conservative treatment. Where back pain is severe, chronic, and significantly disrupting a patient’s quality of life it may be necessary to relieve symptoms by carrying out back surgery for spinal cysts.