Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentA Word from Verywell
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
A Word from Verywell
Spinal synovial cysts are benign fluid-filled sacs in the joints of the spine. They form because of degeneration or injury (as a way to protect the injury). These cysts are not uncommon. They may cause pain and lead to other spinal conditions.
Spinal synovial cysts typically develop in thefacet joints, which are the junctions that keep the vertebrae (spinal bones) interlocked. The cysts can occur anywhere in the spine, and most of them occur in the lumbar region (low back).
nico_blue / Getty Images
For most people, synovial cysts won’t cause any symptoms. If a synovial cyst is compressing a nerve, it can cause back pain, weakness, or numbness.
Synovial cysts can affect one side of the spine or both, and they can occur at one spinal segment or at multiple levels. The severity of symptoms depends on the size and location of a cyst.
Most of the time cysts causeradiculopathydue to irritation of aspinal nerve.
Effects of a synovial cyst can include:
Synovial cysts in the mid-back and neck are rare. When they do occur, thoracic synovial cysts and cervical synovial cysts may cause a range of symptoms, such as numbness, tingling, pain, or weakness.
With wear and tear, facet joint cartilage (the springy material in a joint that provides protection, a smooth surface, friction reduction, and shock absorption) erodes. In the process,the synoviummay form a cyst.
Traumas both large and small have degenerative and inflammatory effects on joints as well, which may result in the formation of a synovial cyst.
About a third of people who have a spinal synovial cyst also have a condition known asspondylolisthesis, This condition is when a vertabra slips out of place or out of alignment onto the vertebra below it. It’s a sign of instability in the spine.
Instability can occur at any area of the spine, but L4-5 is the most common level. This segment of the spine tends to bear the most weight. If instability occurs, a cyst can develop. However, it is important to note that cysts can form without instability.
Cysts are generally diagnosed via magnetic resonance imaging (MRI).They can also sometimes be seen with ultrasound, X-ray, or computed tomography (CT) scan.
Some cysts remain small and cause few, if any, symptoms. Cysts only need treatment if they are causing symptoms.
Lifestyle Changes
Your healthcare professionals may suggest that you avoid certain activities that aggravate your symptoms.
You might be advised to stretch and to begin exercises that do not exacerbate your condition. Physical therapy or occupational therapy may also be recommended.
Intermittent use of over-the-counter nonsteroidal anti-inflammatories (NSAIDs) like Advil (ibuprofen) and Aleve (naproxen) may help relieve occasional pain.
Outpatient Procedures
For cysts that cause significant pain, numbness, weakness, and other issues, an aspiration procedure to drain fluid from the cyst can be beneficial.
In one study, researchers found that the success rate for these procedures ranges from 0 percent to 50 percent. People who undergo aspiration often need repeat procedures if the fluid build-up returns.
Epiduralcorticosteroidinjections can reduce inflammation and may be a suitable option to relieve significant pain. It’s recommended that patients receive no more than three corticosteroid injections per year.
Surgical Options
For more severe or persistent cases, doctors may recommend decompression surgery to remove the cyst and surrounding bone, which should relieve pressure on the nerve root.
There are several surgical options that range from minimally invasive endoscopic procedures to larger, open surgeries. The best surgical option for each patient varies based on the severity of their situation and whether associated disorders are present.
Surgical options include:
Most people experience immediate pain relief following a laminectomy or hemilaminectomy. Fusion can take six to nine months to fully heal.
If surgery is performed withoutfusion of the joints where the cyst originated, the pain may return and another cyst may form within two years.
These surgeries are not without risk. Complications may include infection, bleeding, and injury to the spinal cord or nerve root.
If a spinal synovial cyst is causing symptoms, there are treatments that can help. If your cyst isn’t causing symptoms, your doctor will follow up with you to monitor for signs of degenerative disc disease,spinal stenosis, or cauda equina syndrome.
Cysts, Tumors, and Other Causes of Lower Back Pain
4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Epstein NE, Baisden J.The diagnosis and management of synovial cysts: Efficacy of surgery versus cyst aspiration.Surg Neurol Int. 2012;3(Suppl 3):S157-66. doi:10.4103/2152-7806.98576
Bydon M, Papadimitriou K, Witham T, et al.Treatment of spinal synovial cysts.World Neurosurg. 2013;79(2):375-80. doi:10.1016/j.wneu.2012.08.016Denis DR, Hirt D, Shah S, Lu DC, Holly LT.Minimally invasive surgery for lumbar synovial cysts with coexisting degenerative spondylolisthesis.Int J Spine Surg. 2016;10:37. Published 2016 Oct 24. doi:10.14444/3037Epstein NE, Baisden J.The diagnosis and management of synovial cysts: Efficacy of surgery versus cyst aspiration.Surg Neurol Int. 2012;3(Suppl 3):S157-66. doi:10.4103/2152-7806.98576Xu R, Mcgirt MJ, Parker SL, et al.Factors associated with recurrent back pain and cyst recurrence after surgical resection of one hundred ninety-five spinal synovial cysts: analysis of one hundred sixty-seven consecutive cases.Spine. 2010;35(10):1044-53. doi:10.1097/BRS.0b013e3181bdafed
Bydon M, Papadimitriou K, Witham T, et al.Treatment of spinal synovial cysts.World Neurosurg. 2013;79(2):375-80. doi:10.1016/j.wneu.2012.08.016
Denis DR, Hirt D, Shah S, Lu DC, Holly LT.Minimally invasive surgery for lumbar synovial cysts with coexisting degenerative spondylolisthesis.Int J Spine Surg. 2016;10:37. Published 2016 Oct 24. doi:10.14444/3037
Xu R, Mcgirt MJ, Parker SL, et al.Factors associated with recurrent back pain and cyst recurrence after surgical resection of one hundred ninety-five spinal synovial cysts: analysis of one hundred sixty-seven consecutive cases.Spine. 2010;35(10):1044-53. doi:10.1097/BRS.0b013e3181bdafed
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
