• World Neurosurg · Aug 2019

    Case Reports

    Resolution of symptomatic lumbar synovial cyst after traumatic event.

    • Nathan J Nordmann, Alex P Michael, and Jose A Espinosa.
    • Division of Neurosurgery, Southern Illinois University School of Medicine, Springfield, Illinois, USA. Electronic address: nnordmann93@siumed.edu.
    • World Neurosurg. 2019 Aug 1; 128: 69-71.

    BackgroundSynovial cysts are most commonly found in the lumbar spine and are associated with low back pain and radiculopathy. Frequent use of imaging modalities has led to an increase in intraspinal synovial cyst identification. Treatment typically ranges from conservative measures to surgical decompression, but spontaneous resolution has previously been reported. Here, we present the first report of symptomatic lumbar synovial cyst resolution after a traumatic fall.Case DescriptionWe present a case of a symptomatic synovial cyst between the fourth (L4) and fifth (L5) lumbar vertebrae identified on magnetic resonance imaging (MRI). The patient presented with right paramedian back pain and right-sided L5 radiculopathy. She underwent unsuccessful trials of antiinflammatory agents and physical therapy. Less than 1 year since initial diagnosis, the patient sustained a mechanic fall followed by resolution of prior symptoms. A subsequent lumbar MRI revealed complete resolution of the intraspinal synovial cyst.ConclusionsThe diagnosis of synovial cysts are increasing in frequency due to their ease of identification with computed tomography and MRI. For cases of refractory pain and/or neurologic deficits, surgical decompression is usually necessary. In rare instances, synovial cysts may spontaneously regress or resolve secondary to other events. This is the first description of resolution after a traumatic fall. Due to limited data on this topic, this report may provide additional insight into the pathophysiology of synovial cyst formation and resolution.Copyright © 2019 Elsevier Inc. All rights reserved.

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