Case Review Series: Lumbar Synovial Cyst: How Urgent is Surgery?

In the Case Review Series, Dr. Kimball walks through a variety of real-life patient cases, reviews films and discusses past, planned or completed treatments for the patient. Check out more case reviews on the Case Review Series Playlist.

[@wildflowersnhoney209]

47 yrs old and I have a synovial cyst at L4-L5. Experiencing sciatica like pain thats been increasing for the past year. Shooting, cramping pain down my left leg when I am in any position except laying flat on my back or stomach. I want it fixed asap but worry about the length of time I will need to be off work.

[@rosebuhr]

I am 67; I have just had an MRI that showed a synovial cyst at L4/L5. Thanks so much for explaining it so patiently. I believe I have instability too. Lots of pain down my right leg. I’m only seeing the neurologist in three days. It is soooo painful. Thanks for a great video. Greetings from South Africa 🇿🇦

[@steveanderson1058]

Can we have an update

[@mattcarman1772]

I have the same in same place. Surgery on June 23. How are you doing Rose Buhr?

[@steveanderson1058]

I feel a lot better hearing this. I have a cyst at L3/4 pain is horrible. Can only walk about 5 min then my leg is completely numb. Seeing Dr in 2 weeks. I can barely work. I'm 60 and active. It's difficult to go to the gym but I still go a bit.

[@SassyShay7]

Mine was found in surgury. Was the size of a marble shooter. Massive pain for a year and all the while told I had a L5-S1 herniation because that's what it looked like on scans. Telling people they don't cause pain is iincorrect. Mine was 8/9 for the last 6 months before surgury.

[@JeanStAubin-nl9uo]

This was very informative. Thank you for saying I shouldn't be afraid that I will get incontinent from this right away.

[@reidbrian08]

Thank you for making this video

[@svowels1]

Thank you so much for this video. I just went through this. I had symptoms on and off for the past 3 years and finally had it diagnosed. I had minimally invasive surgery to remove the cyst and I had instant relief.

[@jodysantoni6985]

Where did you get minimal invasive surgery?. I have exact same problems

[@svowels1]

@@jodysantoni6985 I had it done in Naples FL at Physician's Regional Hospital on 3/27/2024. Best decision for me!

[@lockupkeeper]

@@jodysantoni6985I gotta have the same at the end of the month

[@angiebutcher4068]

I appreciate your honesty. I have a synovial cyst and I it is more than likely causing my sciatica pain. Surgery scares me to no end for this. My question is - can synovial cyst burst or move away. I am a Christian and believe I will follow what I need to do, however I am not above being touched and healed as well by Jehovah Rapha. Thank you!

[@PhatFreddysCat]

Couldnt move, couldnt stop it. Thought id need ambulance. Husband helpless. I eventually slowly moved off bed to standing. Stayed standing against br door. Slowly made way to hall & sat on small table. Eventually it eased away but damn that scared me. Im calling Neurosurgeon in a.m.!

[@lauraboudreaux6581]

Is edema on the spine serious? I was diagnosed with mild neural foraminal stenosis with bilateral hypertrophy and arthropathy, spinal osteoarthritis, facet joint.

[@jodysantoni6985]

Please, I need help. i have a synovial cyst in my L5 and facet joint degeneration, its Terrible its been 18.5 mos. I've had the epidural, everything, all the physio, treatments, and everything. It's terrible pain and ruining my life. Please, i would love an opinion. The doctor said they could do surgery, and im scared.

[@NiborL1]

I was diagnosed with synovial cysts and recommended ollif surgery and would love a second opinion 46yr old

[@kurtwiesjahn6183]

Hey where are you located I've had a fusion with 2 fake disk put in now there saying I have a synovial cyst in a dangerous area and one disk is bulging above the fusion im 60 yrs. Old in severe pain just had a new mri monday just dont know what to do anymore im off work because to much pain

[@plookie1972]

i have a 1 inch synovial cyst on my l4 disc. i feel pain every time i step with my left foot . i do not want a 2 level fusion . Can the cyst be aspirated to relieve pain .

[@shannonguevara5896]

I have a cyst on my L4 which causes extreme pain and tingling that goes up my back. Why? It's measurement is 1.6 x 1.1 x 2.6. Us this considered small or big?

[@JeanStAubin-nl9uo]

I am scheduled to have an aspiration of my lumbar synovial cyst as I can't have surgery. A radiologist does this procedure. He/she goes in with a needle and drains the cyst. Why can't I find anything on this procedure? I have been looking for months.

[@JeanStAubin-nl9uo]

I'm following up. I did have the cyst aspiration two months ago. They could not burst the cyst but they did drain a little fluid out of it and gave me an injection of cortisone-type stuff. I had an amazing amount of relief! However, it only lasted two months. The cyst grew from 13mm to 18mm in that short amount of time. I'm going to have the procedure again in the hopes that I will get much longer pain relief.

[@Michelle-ds1rb]

I know this is an old post, but curious of your outcome? Scheduled for aspiration this week and wondering if it’s a waste of time? Large synovial cyst L3-4. Thinking I need to bite the bullet and just do the surgery. Ugh!!! Hope you’re better and doing FANTASTIC.

[@PhatFreddysCat]

I just had an incredibly painful experience that shot me out of dead sleep screaming. I have L4L5 synovial cyst w spinal stenosis & left leg instability blah blah. My entire left leg & buttock felt like a huge electric charlie horse

[@thegraciousgardener92]

I need help Dr. I have severe pain in my lower lumbar which I was told was sciatica. I couldn't get comfortable in any position whether laying down on my stomach back or side, standing or sitting. I couldn't squat or stoop down at all. The pain covered my lower lumbar down my left hip thigh leg and to my foot. The pain grew to my right abdomen as well. When I sit the nerve pain would shoot through my right lower quad area.I was told I have a senovial cyst pressing against my sciatic nerve in my L5 region plus some deterioration and arthritis. The Dr. Suggested a steroid spinal injection. It helped for about a week but now the symptoms are slowly retuning. My lower back feels extremely tight almost as if it would snap if I bend. It's been a month now since the injection and the Dr just suggested that he go in with a needle and fill the senovial cyst with fluid to burst it and for me to get physical therapy. That just doesn't sit right with me. Filling a cyst in my vertebrae that's pressing on my sciatic nerve to burst it? I need a second opinion. He's more of a sports orthopedic and does not perform surgeries so I think I may need a orthopedic surgeon to help me. Please advise.

[@thegraciousgardener92]

I also have stenosis along with the synovial cyst

[@charlesrobbins2208]

I have synovial cysts which had me in unreal pain and I experienced almost total lack of mobility, i experienced numbness which crept up my legs, I had saddle numbness and I thought for sure that surgery was indicated. I obtained a walker, which at first was difficult to use as I was experiencing severe pain with motion. Gradually, I began to be more mobile, I still experienced weakness and had trouble standing without something to hold on to. After about four months of using the walker, my leg strength came back, the numbing sensation almost disappeared and I stopped using the walker. I still experience occasional weakness which is mostly exhibited when attempting to stand up from either a sitting or prone position. I am not a doctor. I am not sure what has happened to ease the pain, but, my guess would be that either the cyst(s) moved or drained themselves somehow? If you don't mind taking a guess, could you offer another possibility? I will not take it as medical advice, I am truly puzzled how this condition can vary so much in it's symptoms, which once had me nearly incapacitated and now allows me to be somewhat mobile without having to use a walker. If not, thank you for your time and trouble. The video is very informative.

[@angiebutcher4068]

My prayer is that my synovial cyst drains or move. It is giving me sciatica, but I am also taking ALA Alpha Lipioc Acid and it seems to help. I am praying Gods hand moves mine without surgery

[@thebryanpereira]

Dr. Kimball, I'm 27 y/o and have recently had a cyst surface near my spine. I doesn't hurt to touch but it's bothersome to know It's there In the first place. I have myopia and believe that my sight cause this cyst as I have always had an imbalance when standing straight or walking... Please let me know If you're able to do a telehealth call or a video review to let me of any advice I could use In my circumstance.