Intraspinal Lumbar Synovial Cysts I.
Overview of the Topic

Czech version

Authors: M. Häckel; P. Vaněk
Authors‘ workplace: Neurochirurgická klinika 1. LF UK a IPVZ, ÚVN Praha
Published in: Cesk Slov Neurol N 2009; 72/105(1): 18-23
Category: Review Article

Overview

The article provides an overview of literature on the history, epidemiology and progress in the diagnosis and treatment of intraspinal synovial cysts in the lumbar spine (ILSC). ILSC are pathological protrusions of synovial lining. From the pathophysiological point of view, it is necessary to distinguish between ILSC and atypical lumbar cysts classified under the term “discal cysts”. The diagnostic method used for the detection of ILSC is magnetic resonance imaging (MRI). Conservative methods, analgesic and physiatric treatment may have a positive effect in some patients and should precede surgical treatment in symptomatic cysts except for those ILSC which cause paretic neurological symptoms, generate pressure or endanger the CNS (the spinal cord). Mini invasive methods (corticoid injections, etc.) have a good effect in a large portion of patients. However, the effect is limited in time in a considerable percentage of patients who suffer from recurrent symptoms. Surgical treatment of the disease consists in the resection of the cysts and decompression, mostly by means of laminectomy. Discussion concerning the use of primary arthrodesis simultaneously with decompression continues and there are still no comparative valid studies available. The article is followed up by the article Intraspinal lumbar synovial cysts II. Own results.

Key words:
lumbar synovi al cysts – degenerative disease of the lumbal spine – radicular signs and symptoms – decompression of the spinal canal

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