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A synovial cyst of the spine is a fluid-filled sac that develops along the spine.
A synovial spinal cyst is the result of degeneration of a facet joint of the vertebrae of the spine.
Most develop in the portion of the lower spine called the lumbar spine.
These cysts are uncommon.
Generally do not produce symptoms.
They may cause issues similar to spinal stenosis.
Symptoms increase as pressure increases.
Symptoms include pain and cramping in the back and legs, and are often worse with standing.
A degenerated facet joint produces more fluid than a healthy joint, and provides extra lubrication and helps ease the joint’s movements.
A cyst may develop in response to the extra fluid, as it can get caught in the synovial lining of the joint forming a cyst.
The fluid in the cyst is not dangerous. It’s not under any pressure and won’t cause any problems until it begins pushing on the spine. Even very large cysts are rarely a problem.
It is rare that someone under 50 years of age will develop a synovial cyst
Symptoms include:
pain in the lower back
pain in one or both legs
pain that radiates down the back of the leg and to the feet
painful cramping in the legs
numbness or tingling in one or both legs
increased pain and symptoms when standing that relieves or eases when sitting
Synovial cysts are best diagnosed by MRI.
Other imaging tests like an X-ray or ultrasound may also be able to detect the cyst.
Nonsurgical treatment options for a synovial cyst include:
Pain medications
Observation
Activity modification
Mild stretching and exercise may help.
Fluid from the cyst may be drained through the facet joint.
An epidural steroid injection, may be used to treat pain caused by a synovial cyst, aiming to temporarily reducing the pain caused by the cyst.
If these nonsurgical conservative treatments do not work, surgery to remove the cyst is recommended.
Synovial cysts are rarely dangerous.