Facet joint synovial cyst

Case contributed by Dr Andrew Dixon

Presentation

Left sciatica. ? cause

Patient Data

Age: 75 years
Gender: Female
MRI

Lumbar spine MRI

There is desiccation of the lumbar intervertebral discs with symmetric disc bulging, except at the L5-S1 disc which appears normal.  At L3-4 and L4-5 facet joint capsular hypertrophy and ligamentum flavum hypertrophy combine with disc bulging to result in moderate and moderate to severe canal stenosis respectively, with bilateral subarticular recess narrowing and mild foraminal stenoses. At L5 there is a round cyst centered in the left posterior epidural space almost certainly representing a facet joint synovial cyst arising from the degenerate left L4-5 facet joint. The synovial cyst contacts the exiting left L5 nerve root as it enters the neural foramen, and anteriorly displaces and compresses the left S1 nerve root within the subarticular recess.     

Case Discussion

Left sided facet joint synovial cyst at L5 contacting the exiting left L5 nerve root and compressing the traversing left S1 nerve root within the subarticular recess. 

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Case information

rID: 62626
Published: 25th Aug 2018
Last edited: 26th Aug 2018
Inclusion in quiz mode: Included

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