scholarly journals Intradural synovial cyst of the upper cervical spine: A rare cause of symptomatic cord compression

2020 ◽  
Vol 11 ◽  
pp. 190
Author(s):  
Yahya H. Khormi ◽  
Ryan Chrenek ◽  
Sankar Tejas
Keyword(s):  
Synovial Cyst ◽  
Cord Compression ◽  
Neurophysiological Monitoring ◽  
Posterior Arch ◽  
Upper Cervical Spine ◽  
Histopathological Diagnosis ◽  
Lumbar Region ◽  
Cyst Excision ◽  
Upper Cervical ◽  
Synovial Cysts

Background: Synovial cysts are commonly observed soft-tissue masses of the spine, typically extradural and located in the lumbar region. We describe a very rare symptomatic case of a C1-C2 intradural synovial cyst. Case Description: A 78-year-old female presented with progressive left side weakness, paresthesia, and hyperreflexia. The magnetic resonance imaging revealed a well-circumscribed, subtly enhancing lesion medial to the C1-2 facet, causing cord compression and edema. Using neurophysiological monitoring, surgery included a modified laminectomy of C2 with the removal of the C1 posterior arch. When the dura was opened, a sizable intradural extramedullary lesion was encountered, the cyst was successfully drained and partially resected. The histopathological diagnosis was consistent with a synovial cyst. Postoperatively, the patient’s strength on the left side improved gradually until she was fully ambulatory. Postoperative imaging showed no recurrence at 8 months follow-up. Conclusion: Synovial cysts should be considered among the differential diagnose of C1-2 cysts. They can occur intradurally and compress the spinal cord resulting in a significant neurological deficit. Cyst excision may be accomplished utilizing a limited laminectomy for cyst identification and drainage, accompanied by partial resection of the cyst wall. Such intervention can lead to good clinical outcomes.

scholarly journals Os Odontoideum: an unusual association of compressive synovial cyst. Case report and review of the literature

2015 ◽  
Vol 42 (S1) ◽  
pp. S50-S50
Author(s):  
AA Ahmed ◽  
T Watson ◽  
A Elgheriani ◽  
E Kachur ◽  
A Cenic
Keyword(s):  
Spinal Cord ◽  
Synovial Cyst ◽  
Cord Compression ◽  
Atlantoaxial Instability ◽  
Os Odontoideum ◽  
Complete Regression ◽  
Cyst Excision ◽  
Persistent Symptoms ◽  
Atlantoaxial Stabilization ◽  
Synovial Cysts

Background: Os odontoideum is a rare cervical abnormality that harbours a potential risk for atlantoaxial instability. In rare circumstances, synovial cysts may develop and compromise the spinal cord. Therefore, cyst excision has been suggested as part of the surgical management. However, in recent reports, it has been shown that atlantoaxial stabilization alone is sufficient for synovial cyst regression. Methodology: 48-year-old woman presented with symptoms and signs of cervical myelopathy secondary to os odontoideum with atlantoaxial instability. A large synovial cyst was diagnosed with significant spinal cord compression. In addition, her spinal and cranial imaging was suggestive of multiple sclerosis which was confirmed clinically thereafter with one episode of MS flare up and positive cerebrospinal fluid analysis. Results: After she had recovered from her MS flare up, posterior atlantoaxial instrumentation and fusion was performed without synovial cyst resection. Postoperatively, her clinical condition improved substantially and complete regression of the synovial cyst was noted on cervical MRI. Interestingly, she has not had any MS recurrent episodes after the surgery. Conclusion: Degenerative changes in os odontoideum are consequences of atlantoaxial instability. Compressive synovial cysts may develop with associated cord compression. We recommend posterior atlantoaxial stabilization alone in such conditions while preserving cyst fenestration or excision for persistent symptoms related to unresolved synovial cysts.

scholarly journals Bilateral mirror-like image of cervical synovial cyst in adults

2019 ◽  
Vol 2 (2) ◽  
pp. 30-32
Author(s):  
Farid Yudoyono ◽  
Deasy Herminawaty ◽  
Hendra ◽  
Dewi Pratiwi ◽  
Nasofi Tri Ramdhani
Keyword(s):  
Amorphous Materials ◽  
Fibrous Tissue ◽  
Synovial Cyst ◽  
Cord Compression ◽  
Cystic Mass ◽  
Neurological Deficits ◽  
Facet Joints ◽  
Increased Sensitivity ◽  
Synovial Cysts ◽  
Sensitivity To Pain

Cervical synovial cysts (SC), however uncommon, can cause radiculopathy and myelopathy. In this study, we report a case of a cervical synovial cyst presented as myelopathy. A 48-year-old man presented with gait disturbance decreased touch senses and increased sensitivity to pain below the C5 level. Magnetic resonance imaging revealed a 0.3-mm, bilateral mirror-like small cystic lesion in the spinal canal with cord compression at the C5-6 level. We performed a bilateral expansive laminoplasty of C5 using a posterior approach and completely removed the cystic mass. Histological examination of the resected mass revealed fibrous tissue fragments with amorphous materials and granulation tissue compatible with a synovial cyst. The patient’s symptoms resolved within 3 months after surgery. Although cervical SC is often associated with degenerative facet joints, clinicians must be aware that SC may lead to neurological deficits.

scholarly journals Surgically Managed Symptomatic Intraspinal Lumbar Facet Synovial Cyst: Outcome of surgical treatment with resection and instrumented posterolateral fusion, a case series.

2021 ◽  
Author(s):  
Lyonel Beaulieu Lalanne ◽  
Facundo Alvarez Lemos ◽  
Roberto Larrondo Carmona ◽  
Juan Ignacio Cirillo Totera ◽  
Andre Beaulieu Montoya ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Retrospective Review ◽  
Symptom Relief ◽  
Case Series ◽  
Synovial Cyst ◽  
Lumbar Region ◽  
Number Of Patients ◽  
Surgical Data ◽  
Synovial Cysts ◽  
Axial Pain

Abstract PURPOSE: There is controversy regarding the treatment of symptomatic synovial cysts (SSC), specifically, the need for a concomitant fusion when surgical resection of the CS is required. We present a retrospective review of a series of patients treated for SSC of the lumbar region during the last 20 years by a single surgeon, analyzing the current available literature. METHODS: Retrospective review. The same surgical technique was applied to all patients. Demographic, clinical, surgical data and synovial cyst recurrence rate were recorded. Postoperative results reported by patients were documented according to the McNab score. RESULTS: 69 subjects, with mean follow-up of 7.4 years. 62% (43) were female, with a mean 57.8 years at the time of surgery. In 91.3% (63), the primary management was conservative for a minimum period of 3 months. All subjects underwent surgery due to the failure of conservative treatment. The segment most operated on was L4-L5 (63.77%). 91.3% (63) of the sample reported excellent and good and 6 subjects (8.6%) fair or poor results. There was no evidence of CS recurrence at the operated level. CONCLUSION: In SSC, it seems that conservative treatment is only effective in a limited number of patients and in the short term. Thus, the recommendation of a surgical indication should proceed as soon as the conservative management fails to result in significant symptom relief. Based on our results, we recommend, together with the resection of the cyst, the instrumentation of the segment to avoid its recurrence and the management of axial pain.

Synovial cyst of the upper cervical spine: MRI with gadolinium

Neurology ◽  
1993 ◽  
Vol 43 (10) ◽  
pp. 2151-2151 ◽  
Author(s):  
C. A. Weymann ◽  
P. Capone ◽  
P. R. Kinkel ◽  
W. R. Kinkel
Keyword(s):  
Cervical Spine ◽  
Synovial Cyst ◽  
Upper Cervical Spine ◽  
Upper Cervical ◽  
Spine Mri

Ventral C1 Fracture Combined with Congenital Posterior Cleft: What to Do?

2017 ◽  
Vol 79 (01) ◽  
pp. 066-072
Author(s):  
Philipp Dammann ◽  
Tobias Schoemberg ◽  
Yahya Ahmadipour ◽  
Michael Payer ◽  
Ulrich Sure ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Full Range ◽  
Rare Condition ◽  
Posterior Arch ◽  
Upper Cervical Spine ◽  
Spine Mobility ◽  
Upper Cervical ◽  
Congenital Cleft ◽  
Transverse Atlantal Ligament

Background and Objective We present a treatment approach for a rare condition of patients with a ventral C1 fracture and a congenital cleft in the posterior arch (half-ring Jefferson fracture) with an intact transverse atlantal ligament. Our technique aims to achieve stability of the atlanto-occipital and atlantoaxial joints while preserving mobility of the upper cervical spine. Patients and Methods Two male patients, 43 years and 29 years of age, respectively, were admitted to our hospital due to a fracture of the ventral arch of the atlas with no damage of the transverse atlantal ligament. Both men also presented a congenital cleft of the posterior arch. Initial conservative management with a halo-thoracic vest was performed in one case and failed. As a result, surgical treatment was performed in both cases using bilateral C1 mass screws and a transverse connector. Results The patients showed no neurologic deficits on follow-up examination 4 weeks after surgery with a full range of head and neck motion. Computed tomography (CT) showed no dislocation of the implanted material with good dorsal alignment and a stable ventral fracture distance. Follow-up CT showed osseous stability in both cases with the beginning of bony ossification of the bone graft. Conclusion Isolated instable fractures of the ventral arch of the atlas with a congenital cleft of the posterior arch with no damage of the transverse atlantal ligament can be stabilized using bilateral C1 mass screws and a transverse connector preserving upper cervical spine mobility.

scholarly journals Pseudogout of the Transverse Atlantal Ligament: An Unusual Cause of Cervical Myelopathy

2004 ◽  
Vol 31 (2) ◽  
pp. 273-275 ◽  
Author(s):  
Donald E.G. Griesdale ◽  
Mike Boyd ◽  
Ramesh L. Sahjpaul
Keyword(s):  
Cervical Spine ◽  
Cervical Myelopathy ◽  
Healthy Woman ◽  
Cord Compression ◽  
Calcium Pyrophosphate ◽  
Craniocervical Junction ◽  
Upper Cervical Spine ◽  
Calcium Pyrophosphate Dihydrate ◽  
Upper Cervical ◽  
Pyrophosphate Dihydrate

AbstractBackground:Calcium pyrophosphate dihydrate deposition in the cervical spine is infrequently symptomatic. This is especially true at the craniocervical junction and upper cervical spine.Case Report:A 70-year-old previously healthy woman presented with a progressive cervical myelopathy of four months duration.Results:Examination revealed sensorimotor findings consistent with an upper cervical myelopathy. Radiological studies (plain radiographs, computed tomography, and magnetic resonance imaging) revealed C1-2 instability, and a well-defined extradural 3cm x 1cm retro-odontoid mass causing spinal cord compression. Transoral resection of the mass was performed followed by posterior C1-2 stabilization. Histological examination of the mass confirmed calcium pyrophosphate dihydrate deposition. Follow-up examination showed marked clinical and radiological improvement.Conclusion:Although uncommon, calcium pyrophosphate dihydrate deposition disease should be considered in the differential diagnosis of extradural mass lesions in the region of the odontoid.

Endoscopic, endonasal decompression of spinal stenosis with myelopathy secondary to cranio-vertebral tuberculosis: two cases

2009 ◽  
Vol 124 (7) ◽  
pp. 816-819 ◽  
Author(s):  
P Puraviappan ◽  
I P Tang ◽  
D J Yong ◽  
N Prepageran ◽  
R L Carrau ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Case Reports ◽  
Cord Compression ◽  
Upper Cervical Spine ◽  
Surgical Trauma ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Upper Cervical ◽  
Bulbar Dysfunction

AbstractBackground:Tuberculosis can cause extensive osseo-ligamentous destruction at the cranio-vertebral junction, leading to atlanto-axial instability and compression of vital cervico-medullary centres. This may manifest as quadriparesis, bulbar dysfunction and respiratory insufficiency.Aim:We report two patients presenting with spinal stenosis and cord compression secondary to cranio-vertebral tuberculosis, who were successfully decompressed via an endoscopic, endonasal approach.Study design:Two case reports.Methods and results:Both patients were successfully decompressed via an endoscopic, endonasal approach which provided access to the cranio-vertebral junction and upper cervical spine.Conclusion:An endoscopic, endonasal approach is feasible for the surgical management of cranio-vertebral junction stenosis; such an approach minimises surgical trauma to critical structures, reducing post-operative morbidity and the duration of hospital stay.

scholarly journals Incidence and Variants of Posterior Arch Defects of the Atlas Vertebra

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Sebastian Guenkel ◽  
Sladjana Schlaepfer ◽  
Sonja Gordic ◽  
Guido A. Wanner ◽  
Hans-Peter Simmen ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Congenital Anomalies ◽  
Caucasian Population ◽  
Ct Scans ◽  
Posterior Arch ◽  
Upper Cervical Spine ◽  
Anterior Arch ◽  
Predominant Type ◽  
Upper Cervical ◽  
Posterior Arch Defects

In order to describe the incidence and existing variants of congenital anomalies of the atlas vertebrae in a Caucasian population, we examined 1069 CT scans of the upper cervical spine. We found 41 cases with altered atlas vertebrae, representing 3.8% of all analyzed patients. With 83% of all found anomalies, the predominant type is characterized by a small dorsal cleft (3.2% of all patients). Rare varieties feature unilateral or bilateral dorsal arch defects, combined anterior and posterior clefts (0.2% of all patients) or total erratic atlas vertebra malformation (0.1% of all patients). Atlas arch defects are found nearly 4% at the time. Most anomalies affect the posterior arch, whereas the anterior arch or both are rarely affected. Totally irregular C1 vertebrae are extremely infrequent.

scholarly journals Can lumbar hemorrhagic synovial cyst cause acute radicular compression? Case report

2014 ◽  
Vol 12 (4) ◽  
pp. 509-512 ◽  
Author(s):  
Luciana Sátiro Timbó ◽  
Laercio Alberto Rosemberg ◽  
Reynaldo André Brandt ◽  
Ricardo Botticini Peres ◽  
Olavo Kyosen Nakamura ◽  
...  
Keyword(s):  
Bleeding Complication ◽  
Anticoagulation Therapy ◽  
Synovial Cyst ◽  
Cord Compression ◽  
Compression Syndrome ◽  
Gradual Onset ◽  
Synovial Cysts ◽  
Spinal Cord Compression Syndrome ◽  
The Right ◽  
Radicular Compression

Lumbar synovial cysts are an uncommon cause of back pain and radiculopathy, usually manifesting with gradual onset of symptoms, secondary to involvement of the spinal canal. Rarely, intracyst hemorrhage occurs, and may acutely present as radicular - or even spinal cord - compression syndrome. Synovial cysts are generally associated with degenerative facets, although the pathogenesis has not been entirely established. We report a case of bleeding complication in a synovial cyst at L2-L3, adjacent to the right interfacet joint, causing acute pain and radiculopathy in a patient on anticoagulation therapy who required surgical resection.

scholarly journals A Rare T2-T3 Synovial Facet Cyst Causing Progressive Myelopathy

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Mohamed F. Albana ◽  
Sean Z. Griffiths ◽  
Kris E. Radcliff
Keyword(s):  
Spinal Cord ◽  
Synovial Cyst ◽  
Thoracic Myelopathy ◽  
Cyst Excision ◽  
Progressive Myelopathy ◽  
Recommended Treatment ◽  
Cord Injury ◽  
Synovial Cysts ◽  
Spinal Cord Level ◽  
Upper Thoracic

Intraspinal extradural synovial cysts are a rare occurrence at the spinal cord level and thus a rare cause of myelopathy. Synovial cysts usually present in the more mobile lumbar and cervical parts of the spine; however, they may also arise in the thoracic spine. We present a case of a 59-year-old male with a left upper thoracic synovial cyst at T2-3 causing disabling, progressive myelopathy, and an incomplete spinal cord injury syndrome with inability to ambulate. An urgent decompressive laminectomy with bilateral facetectomies, cyst excision, and posterior fusion was performed. Subsequently, the patient recovered full function. Synovial cysts should be considered in the differential diagnosis of progressive thoracic myelopathy. This is only the sixth reported case of a synovial cyst of this kind occurring between the levels of T1 and T7. Urgent surgical decompression is the recommended treatment.

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