Document Detail

Hemorrhagic synovial cyst: the possible role of initial trauma and subsequent microtrauma in its pathogenesis: case report.
MedLine Citation:
PMID:  21311282     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND IMPORTANCE: Intraspinal synovial cysts are uncommon causes of back and radicular leg pain. Usually associated with degenerative spinal disease, these juxtafacet cysts are usually located in the lumbar spine and may rarely undergo intracystic hemorrhage. The pathogenesis of these cysts are unclear, and risk factors that may contribute to hemorrhagic complications are largely unknown.
CLINICAL PRESENTATION: A 68-year-old man presented to the clinic 4 months after a fall on ice with persistent back pain and lumbar radiculopathy. A week after the initial clinic consultation, the patient presented to the emergency room with increased pain and worsening weakness in the left foot. An emergent magnetic resonance image showed thecal sac compression secondary to a large, juxtafacet cyst that was hyperintense on T1-weighted and hypointense on T2-weighted images. Lumbar decompressive laminectomies were performed at L3 and L4 with cyst removal and stabilization.
CONCLUSION: We present the eighth reported case of a hemorrhagic juxtafacet cyst secondary to physical trauma, the second in which the patient's symptoms acutely worsened several months after the initial insult without new trauma. We also present summary statistics of the 31 cases of hemorrhagic juxtafacet cysts reported in the literature and propose a putative mechanism that may account for the development and progression of symptoms in some patients.
Risheng Xu; Can Solakoglu; Zahra Maleki; Matthew J McGirt; Ziya L Gokaslan; Ali Bydon
Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Neurosurgery     Volume:  68     ISSN:  1524-4040     ISO Abbreviation:  Neurosurgery     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-11     Completed Date:  2011-06-17     Revised Date:  2011-08-25    
Medline Journal Info:
Nlm Unique ID:  7802914     Medline TA:  Neurosurgery     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E858-65; discussion E865     Citation Subset:  IM    
Department of Neurosurgery, Johns Hopkins University, Johns Hopkins School of Medicine, Baltimore, Maryland 21287, USA.
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MeSH Terms
Back Pain / diagnosis,  etiology
Hemorrhage / diagnosis,  etiology,  surgery
Lumbar Vertebrae / surgery
Radiculopathy / diagnosis,  etiology
Spinal Cord Injuries / complications*,  diagnosis,  surgery*
Synovial Cyst / diagnosis,  etiology*,  surgery*
Treatment Outcome
Zygapophyseal Joint / injuries*,  surgery*

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