The Journal of Bone and Joint Surgery, Vol 67, Issue 6 865-871, Copyright © 1985 by Journal of Bone and Joint Surgery, Inc
Intraspinal synovial cyst causing sciatica
LT Kurz, SR Garfin, AS Unger, RP Thorne and RH Rothman
Four patients who had low-back pain and sciatica were diagnosed as having a
lumbar intraspinal extradural synovial cyst adjacent to a facet joint
between the fourth and fifth lumbar vertebrae. The patients ranged in age
from forty-nine to seventy-one years, and the symptoms and signs involved
the fourth or fifth lumbar-nerve roots. Roentgenographically, degeneration
of the intervertebral discs and facet joints was noted in every patient.
Degenerative spondylolisthesis was also a frequent finding. Myelography and
computed tomographic scans aided in diagnosis, revealing a soft-tissue
lesion, occasionally rimmed with calcification, adjacent to the involved
facet joint. The treatment was surgical excision of the cyst, as well as
complete laminectomy if there was concomitant spinal stenosis. Follow-up,
ranging from eighteen to twenty-five months, revealed complete resolution
of the sciatica in all patients.