There is little evidence for the efficacy of conservative treatments. Examination may reveal motor and sensory disturbance in the upper limbs and upper motor neurone signs in the lower limbs (weakness, increased tone, increased reflexes, and positive Babinski sign).Ĭonservative treatments include physiotherapy, epidural injections, non-steroidal anti-inflammatory drugs (NSAIDs) and other medicines for pain relief as required. The most characteristic symptoms are neck pain with a restricted range of movement of the neck, instability of gait, loss of fine motor control of the upper limbs, weakness and sensory disturbance in upper and lower limbs, and urinary urge incontinence. The lower cervical segments are commonly affected by spinal stenosis but the upper cervical segments are only rarely affected. To sign up for future episodes of Spine Time, where you can ask questions of our spine specialists, subscribe here.Cervical stenosis occurs in 9% of people aged over 70 years. This question was answered during the episode of Spine Time called “Back Pain: When Is Surgery the Answer (and When Isn’t It)?” A recording of this webinar held on June 20, 2020, is available on YouTube. Mike Mizrahi, interventional spine and musculoskeletal medicine specialist (Spinal fusion is surgery to permanently connect two or more vertebrae in your spine, eliminating motion between them.) But if there is some instability associated with the cyst or if the spine is unstable, a fusion is indicated. Most patients do not need a fusion when we remove the cyst. As with disc herniation surgery, the success rate is quite high with this operation. With a decompression cyst resection, we remove the cyst (resection), relieving the pressure from the nerve root. The two most common surgeries for a spinal cyst are a decompression/cyst resection or a decompression cyst resection with a spinal fusion. Some patients don’t respond to these minimally invasive procedures and require surgery. However, many patients choose to go through with a minimally invasive procedure rather than having spine surgery. I do remind patients that spinal cysts often grow back. Cyst rupture is somewhat painful compared to injection only, but it is usually more effective long-term. We try to fill up the cyst with enough medication to pressurize it and ultimately rupture it. If the pain is in the leg and back, we might do an epidural steroid injection combined with a facet joint aspiration or injection.
If the pain is just in the back, we might first try a steroid injection or nerve block. Non-surgical treatments include therapy, medications, and steroid injections with aspiration (drainage). Our treatment plan depends on the cyst’s size, position, and the patient’s symptoms. Treatment options include both surgical and non-surgical methods. Symptoms can be very similar to sciatica or spinal stenosis: lower back pain, leg pain or even leg weakness. When the cyst starts to grow, it can put pressure on a nearby nerve. Q: What are spinal synovial cysts, and how are they treated?Ī: Synovial cysts are cysts in the spine that are caused by a buildup of fluid from nearby a facet joint due to arthritis in the back.
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