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VOLUME 3 , ISSUE 1 ( January-June, 2021 ) > List of Articles

CASE REPORT

Lumbar Facet Cyst Causing Incomplete Cauda Equina Syndrome: A Case Report and Review of Literature

Manoj Ramachandraiah, Thomas J Kishen

Keywords : Cauda equina syndrome, Decompression, Facetal cyst

Citation Information : Ramachandraiah M, Kishen TJ. Lumbar Facet Cyst Causing Incomplete Cauda Equina Syndrome: A Case Report and Review of Literature. 2021; 3 (1):60-62.

DOI: 10.5005/jp-journals-10079-1033

License: CC BY-NC 4.0

Published Online: 07-07-2021

Copyright Statement:  Copyright © 2021; The Author(s).


Abstract

Background: Intraspinal facet cyst or juxta-facet cyst is a term that includes synovial and ganglion cysts in the spine. Facetal synovial cysts are fluid-containing synovial outpouchings arising from degenerated facet joints resulting from chronic hypermobility of the joints. These cysts can cause low back pain, radicular leg pain, and in rare cases cauda equina syndrome. Case description: In this report, we would like to present the occurrence of incomplete cauda equine syndrome resulting from a facet synovial cyst in a 65-year-old woman who presented with weakness in both lower limbs, difficulty in walking, and saddle anesthesia. The symptoms resolved following a posterior decompression, cyst excision, and instrumented fusion surgery. Conclusion: This report highlights the occurrence of acute cauda equina syndrome in a 65-year-old woman resulting from an L4–L5 facet synovial cyst. Prompt diagnosis and immediate surgical intervention in the form of decompression and fusion surgery lead to a favorable outcome. Clinical message: Acute cauda equina syndrome in a patient with a lumbar facet cyst is a relatively uncommon presentation. It requires early diagnosis and immediate surgical intervention in the form of decompression to prevent neurological deterioration and to have a favorable outcome.


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  1. Kao C, Winkler S, Turner J. Synovial cyst of spinal facet. J Neurosurg 1974;41(3):372–376. DOI: 10.3171/jns.1974.41.3.0372.
  2. Tatter S, Cosgrove G. Hemorrhage into a lumbar synovial cyst causing an acute cauda equina syndrome. J Neurosurg 1994;81(3):449–452. DOI: 10.3171/jns.1994.81.3.0449.
  3. Hsu K, Zucherman J, Shea W, et al. Lumbar intraspinal synovial and ganglion cysts (facet cysts). Spine 1995;20(1):80–89. DOI: 10.1097/00007632-199501000-00015.
  4. Machino M, Yukawa Y, Ito K, et al. Spontaneous hemorrhage in an upper lumbar synovial cyst causing subacute cauda equina syndrome. Orthopedics 2012;35(9):e1457–e1460. DOI: 10.3928/01477447-20120822-41.
  5. Eyster E, Scott W. Lumbar synovial cysts: report of eleven cases. Neurosurgery 1989;24(1):112–115. DOI: 10.1227/00006123-198901000-00021.
  6. Epstein N. Lumbar synovial cysts. J Spinal Disord Tech 2004;17(4):321–325. DOI: 10.1097/01.bsd.0000096267.75190.eb.
  7. Christophis P, Asamoto S, Kuchelmeister K, et al. “Juxtafacet cysts”, a misleading name for cystic formations of mobile spine (CYFMOS). Eur Spine J 2007;16(9):1499–1505. DOI: 10.1007/s00586-006-0287-5.
  8. Muir JJ, Pingree MJ, Moeschler SM. Acute cauda equina syndrome secondary to a lumbar synovial cyst. Pain Physic 2012;15(5):435–440. DOI: 10.36076/ppj.2012/15/435.
  9. Iacob G, Rotund B. Lumbar L4-L5 ganglion cyst with hemicauda equina syndrome. Report of a case and review of the literature. Roman Neurosurg 2013;20(4):335–343. DOI: 10.2478/romneu-2013-0017.
  10. Howington J, Connolly E, Voorhies R. Intraspinal synovial cysts: 10-year experience at the Ochsner clinic. J Neurosurg: Spine 1999;91(2):193–199.
  11. Khan A, Synnot K, Cammisa F, et al. Lumbar synovial cysts of the spine. J Spinal Disord Tech 2005;18(2):127–131. DOI: 10.1097/01.bsd.0000156830.68431.70.
  12. Banning C, Thorell W, Leibrock L. Patient outcome after resection of lumbar juxtafacet cysts. Spine 2001;26(8):969–972. DOI: 10.1097/00007632-200104150-00024.
  13. Shah RV, Lutz GE. Lumbar intraspinal synovial cysts: conservative management and review of the world's literature. Spine J 2003;3(6):479–488. DOI: 10.1016/S1529-9430(03)00148-7.
  14. Houten J, Sanderson S, Cooper P. Spontaneous regression of symptomatic lumbar synovial cysts. J Neurosurg: Spine 2003;99(2):235–238. DOI: 10.3171/spi.2003.99.2.0235.
  15. Maezawa Y, Baba H, Uchida K, et al. Spontaneous remission of a solitary intraspinal synovial cyst of the lumbar spine. Eur Spine J 2000;9(1):85–87. DOI: 10.1007/s005860050016.
  16. Swartz PG, Murtagh FR. Spontaneous resolution of an intraspinal synovial cyst. AJNR Am J Neuroradiol 2003;24(6):1261–1263.
  17. Martha JF, Swaim B, Wang DA, et al. Outcome of percutaneous rupture of lumbar synovial cysts: a case series of 101 patients. Spine J 2009;9(11):899–904. DOI: 10.1016/j.spinee.2009.06.010.
  18. Gleave J, MacFarlane R. Cauda equina syndrome: what is the relationship between timing of surgery and outcome. Br J Neurosurg 2002;16(4):325–328. DOI: 10.1080/0268869021000032887.
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