Daniela Linhares, João Lobo, Rui Pinto, Nuno Neves


September 2017, Volume 26, Issue 9, pp 2267 - 2271 Grand Rounds Read Full Article 10.1007/s00586-017-4947-4

First Online: 01 February 2017

Introduction

[InlineMediaObject not available: see fulltext.]Synovial cysts of the cervical spine are rare. These lesions have been associated with other spinal conditions as osteoarthritis, spondylolisthesis, and disc degeneration, with authors postulating a possible link with segmental spinal instability. This study aims to describe an atypically presenting case of a cervical synovial cyst.

Case report

A 65-year-old man presented with complaints of cervical radicular pain (VAS of 7) that evolved with development of paresthesia and muscular weakness, compatible with C8 right compression. This symptomatology had an odd pattern with total regression of symptoms when lying supine or upon extreme efforts, leading to a delayed referral to MRI. A C7–T1 synovial cyst was identified, compressing the C8 nerve root. The patient was submitted to decompression and instrumented fusion of the affected level and showed total regression of symptoms.

Conclusions

Although rare, cervical synovial cysts are associated with a significant impairment in patients’ daily activities. The atypical pattern of symptoms described in this case may be associated with the fluid content of the cyst, with postural changes causing different degrees of root compression. Most authors agree on a surgical option, but the need for associated fusion is still under debate.


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