Comparing Surgical Approaches to Treat Spinal Synovial Cysts

[@jr8870]

Had a 3 cm diameter synovial cyst at L4 removed via L4/L5 decompression laminectomy with L4 facet debridement and no fusion or hardware... Preop had 97% stenosis at L4 with severe traction of left nerve roots to the right causing left buttock, sciatic and radicular pain and numbness in both legs to the ankles... Awoke pain free in Recovery Room and was out of bed walking without assistance that afternoon... Home next day... I’m 70 years old and was back in my surgical practice in one week... Now one month out and would never know I had the surgery... A skilled, experienced neurosurgeon is the key to good results...

[@katvans216]

I have a 1.8 cm synovial cyst at L5-S1. I'm 65 years old and typically very active (tennis, biking, swimming, etc.). I had a "cyst rupture" procedure which helped alleviate the nerve pain - so the severe radicular pain and numbness are largely gone...but the cyst (or remnants) is still there. I have general lower back pain and I can feel the cyst when I do my daily back exercises. I'm intrigued that you had the cyst removed w/o fusion. Are you saying here that you had the laminectomy - I'm not clear about bilateral vs. hemi - and it was successful? My surgeon is not pushing me to have surgery and is suggesting that the next step if I continue suffering from back pain, would be a laminectomy to remove the cyst. I'm just nervous about going through that, then having to go back for fusion. Please describe your recovery. Thank you!

[@checkthisjunkout]

KatVans, what did you eventually do? How did things turn out?

[@Firebirdlady1]

I have had a lumbar synovial cyst removed in 2003 with a laminectomy without a fusion, because the surgeon, "didn't know how to do it". Now it is 2011 and due to the symptoms I am having, I believe the cyst may have recurred. I am not happy at all because I am not looking forward to having another surgery and my chances for this recurring would have been much less, had I been given a fusion in the beginning. Some doctors,,,,,I don't know. Thank you for this video, it is very helpful.

[@mRNADisplay]

Thank you Dr Bydon for this extremely helpful and informative video and publication and for your analysis. I had An L4 L5 facet joint cyst that presented with incapacitating radicular pain Virtually no spinal pain. My physician suggested and I agreed undergo l4 l5 Fusion w laminectomy and cyst removal. 1 week post op I could not be happier. Radicular pain is gone (it was an 8 preop). To me, the most telling feature that you uncovered was that 74 out of 74 patients who underwent fusion did not show cyst recurrence. My Minimally invasive procedure resulted in me being able to walk and function almost immediately w precautions.

[@JohnsHopkinsMedicine]

Thank you for sharing your experience. We will certainly pass your compliment to Dr. Bydon and his team. Have a great weekend!

[@anniev48]

I had an L3/4 right microendoscopic laminectomy and decompression done in May 2019. MRI showed what was thought to be a synovial cyst 10mm x 0.6mm. On operation this was found to be an osteochodrous loose body. No fusion done. I have more lumbar pain and reduced mobility now so it would appear that I am at risk of recurrence of some type

[@rondarawson6236]

So fusion with the removal of the cyst works best for long term....thank you😀❤

[@anthonyhopper7895]

It is inhumane to leave a patient like this.

[@shellyrae777]

I’ve already had a decompression fusion at L4-L5-s1 10 years ago. Now I’ve developed a cyst at L5-s1 causing pain and pelvic numbness. I’m having trouble finding information on how cysts are treated if you’ve already had a laminectomy fusion.

[@JohnsHopkinsMedicine]

Hi, If you would like to request an appointment at one of our hospitals, please call 888-872-1408. Our specially trained medical concierges can arrange consultations or treatment plans with the most appropriate specialists. Johns Hopkins USA can also provide language interpretation, financial counseling, assistance with travel arrangements and anything else to help make Johns Hopkins feel as close to home as possible.

[@MsOscara]

A recent MRI reveals a synovial cyst between L4 & L5, which is causing me severe pain and burning along the sciatic nerve. The surgeons are reluctant to perform surgery because of COVID, my age, and mild scoliosis which might create future spinal instability above the area where the cyst is currently sitting. I had a nerve block procedure performed about a week ago, but it hasn't really done much to help with the pain. Since this presentation is over 10 years old, I was wondering what progress has been made in the treatment of this condition. I've found a few studies where lasers have been used to break up and destroy these cysts. What is the current medical/surgical thinking on the use of lasers as a less invasive form of treatment.

[@anitalopresto]

I have been diagnosed with synovial cyst on L4 L5 having several back groin, and numbness in big toe. I am considering surgery, we love for you or your team to perform it. How do I get in touch...please advise, alot of pain!!

[@tarzan30809]

Anita, did you have the cyst removed?

[@Wendy-kj9ti]

Maureen, that treatment may allow reoccurrence.

[@kfavorite4370]

Sir i m also suffering from LA L5 synovial cyst. So sir i would like to request you to suggest me that is operation is only option? can't it be treated with medication or exercise? Bcz i m very afraid that even if i will be performed by surgery , what if the cyst will recurrent with severe back pain? I humbly requesting you to answer my question! 🙏 I am looking forward to have answers . PLEASE sir answer me .

[@JohnsHopkinsMedicine]

Please reach out to inquire about a new appointment by calling 855-695-4872. Please note, many of our offices are reaching out to patients to reschedule appointments as video visits; this will depend on visit type and currently, these are only available for existing patients. Please call the above number to learn more about what options may be available for your specific situation. You can see more on our patient and visitor guidelines at www.hopkinsmedicine.org/coronavirus/index.html#patient-visitor-alerts

[@ItachisOnly1]

very helpful

[@maryjochappell2987]

what do you mean without fusion? what does fusion mean in action?

[@serafinamarotta]

I have a cervical synovial cyst at C1, it was diagnosed a year ago via MRI. I've started having MS like symptoms and I don't think my neurologist knows what to do about it. Its hard to find any information about this.

[@JohnsHopkinsMedicine]

Hi, Thank you for reaching out to us. We’re very sorry to hear about what you’re going through. Unfortunately, because each person’s medical situation is different, we are unable to provide treatment recommendations or second opinions via this form of communication.If you would like to request an appointment at one of our hospitals, please call 888-872-1408. Our specially trained medical concierges can arrange consultations or treatment plans with the most appropriate specialists. Johns Hopkins USA can also provide language interpretation, assistance with travel arrangements and anything else to help make Johns Hopkins feel as close to home as possible.

[@Wendy-kj9ti]

My son has a golf ball size cyst at S1-L5. Which type of cyst could this be?

[@JohnsHopkinsMedicine]

Hi, thank you for reaching out to us. We’re very sorry to hear about what your son is going through. Unfortunately, because each person’s medical situation is different, we are unable to provide treatment recommendations or second opinions via this form of communication. If you would like to request an appointment at one of our hospitals, please call 888-872-1408. Our specially trained medical concierges can arrange consultations or treatment plans with the most appropriate specialists. Johns Hopkins USA can also provide language interpretation, financial counseling, assistance with travel arrangements and anything else to help make Johns Hopkins feel as close to home as possible.

[@vijaylakshmi5394]

I have cyst in my spine l have pain in right leg numbness in foot please tell me how l can consult thanking you

[@MarkJohnson-zy4fd]

I am sorry, but the incidence of fusion surgery seems completely out of hand. It just seems that when the surgeons are faced with situations when instability MIGHT occur they want to fuse. I know too many people with fused spines that now move like robots.

[@maureenhudak6396]

I have a cyst in the L4-L5 area after having a laminotomy a little over a year ago. I am having a procedure done next week where they are going to inject the cyst with fluid to try to pop it. I am hoping for a good outcome but wondered if anyone else has ever had that done.

[@92lovepreet]

Hi there I am having same problem and going to see neurosurgeon. How did you go ? What’s the outcome ?

[@felicepatel4875]

Hi yes I had a cyst on lower spine 4 years ago and had an MRI to confirm it and then the surgeon put a needle through to drain the cyst and I was back to my fit and flexible self, however the pain has come back after 4 years:( They did say it could come back! I'm waiting for another MRI scan to see if it's the same thing which I think it's similar

[@manishanthwaluk1344]

This is cancer or non cancer

[@debschaal]

A little more non medical terminology we all can understand!