Білатеральні синовіальні кісти поперекового відділу хребта. Клінічний випадок

Abstract

А case of bilateral synovial cysts is reported. Synovial cysts are uncommon extradural degenerative lesions associated with symp­toms of lower back pain and clinical presentation requiring а differential diagnosis versus other root compression disorders, first and foremost lumbar herniated disks. Synovial cysts are mostly unilateral with а few exceptions. Most of these lesions occur in the lumbar spine at the L4/5 level and to а lesser extent at the L5/S І and L3/4 levels. Treatment is based оn conservative therapy with patient immobilisation, on intraarticular injection of steroids, on aspiration of the cyst and оn surgical removal. The case reported here consists of bilateral synovial cysts of articular facets L4/5, different in size, treated with surgery. Symptomatic synovial cysts are usually treated bу resection, due to their potential for recurrence. Surgical resection of synovial cysts is often diffi­cult because the cyst may bе adherent to the dura. Symptomatic synovial cysts of the lumbar spine were associated with degenerative spondylolisthesis in 33 % and with instability of the facet joint in 61 %. This findings may support the theory that increased segmen­tal motion plays role in the pathogenesis of synovial cysts.