I have synovial (ganglion) cyst in my spine. Help?

Synovial cysts commonly may arise throughout the body.  Synovial cysts are sometimes called ganglion cysts.  Synovial cysts that arise in the spinal canal can cause severe back and leg pain.  They are usually small painful cysts located in the epidural space inside the spinal canal.  They arise from degenerated “worn out” spinal facet joints.  They have a fibrous wall and are filled with thick mucus fluid similar to synovial cysts found in other areas of the body.

As synovial cysts grow they cause pressure or “pinch” near by nerves producing pain.  They can also produce numbness, tingling and weakness.  They are usually slow growing but sometimes form rapidly.

Treatment of synovial cysts include: observation, epidural steroid injection, intra-cyst steroid injection to rupture the cyst and surgery.  Surgery usually requires large incision with significant bone and ligament removal to enter the spinal canal and remove the cyst.  Since the degenerated facet joint is the source of the cyst it is possible for the synovial cyst to recur.  Future resections may entail partial or complete removal of the facet joint and lumbar fusion.

Today many of these synovial cysts can be removed through the spinal foramen with little to no bone removal with the spinal endoscope.  Endoscope is a video camera connected to a high definition scope the size of a pen which can be placed into the spine to the synovial cyst for direct visualized removal.  Patients often feel immediate pain relief and are able to return back to normal activity much faster then with traditional open spinal surgery.

For more information on endoscopic spine surgery please see Laser spine surgery and endoscopic spine surgery.

I have low back pain. Do I need physical therapy or MRI?

That is a good question.  Back pain is a very common symptom.  Most people will have back pain at some time during there life.  That said not all back pain is created equal.  Back pain can be good, bad or ugly.

The development of back pain may be a warning from your body that your are straining your back and about to damage it.  This type of back pain can be considered good because it may prevent a more serious injury.  Back pain from injured or herniated disk, or fractures may be bad.  It can cause pain in your back, buttocks, hips, groin and down the legs.  It may be associated with numbness, tingling, weakness and bowel and bladder dysfunction.  Yes a bad disk or fracture may cause you to be incontinent of bowel movements and urination or retain them and not be able to go.  Less serious cause of bad back pain is facet arthritis also called facet arthropathy.  Back pain can get really ugly when it is caused by an infection or cancer.  It can cause weight loss, fever, chills and sweats (called systemic symptoms) and if goes untreated may be life threatening.

Therefore it depends on how your back pain started and if it is associated with anything.  If you simply pulled your back lifting and have no other neurological problems or systemic symptoms then physical therapy is the best place to start, but if you do have other bad or ugly symptoms or fail physical therapy then you should get an MRI scan.

For more information please see the following links:

What Causes Back Pain?

Back Arthritis

What is Sciatica?

Overview of Spinal Stenosis

Spinal Fusion and alternate Options

Kyphoplasty – what is it?

Please Schedule an Appointment to find out more information!