Synovial Cysts by Dr Tony Mork

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Published 2012-10-18
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Dr. Tony Mork, MD | Endoscopic Spine Surgeon
2102 Business Center Dr #127
Irvine, CA 92612

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Dr. Tony Mork demonstrates what synovial cysts in the lumbar spine are and how they cause leg pain.

Today, let's dive into a fascinating topic—synovial cysts in the lumbar spine. We'll explore what they are, their impact on your health, and the various treatment options available.

So, what exactly is a synovial cyst? It occurs as we age, and our joints undergo wear and tear. The fluid builds up in an attempt to lubricate the joints, resulting in pressure and outpouching of the synovial lining. Typically, this condition affects individuals aged 60 years and older, with the most common location being the L4-L5 level. This area experiences significant activity and motion, contributing to its prevalence.

Let's visualize the spine, looking down on a diagram. The disc is located here, and the spinal cord is shown in orange. Adjacent to the disc, we have the facet joint with its pink synovial lining. As fluid accumulates, it forms a fluid-filled cavity, or cyst, which can put pressure on the nerves or, in severe cases, the spinal cord itself.

Now, let's take a look at an MRI scan that aligns with this scenario. You'll notice the disc, vertebrae, spinal cord, and facet joint with its synovial tissue. The white dot represents the synovial cyst, applying pressure on the nerve root or even the spinal cord.

Symptoms of a synovial cyst may vary, but most commonly, it presents as pain in the legs, buttocks, or feet. Weakness and numbness are also potential signs, and in some cases, back pain may be prominent. These symptoms often prompt an MRI scan, allowing for accurate diagnosis.

One way to identify a synovial cyst is through an MRI scan, and additional flexion and extension views of the back can reveal any accompanying motion issues that might be contributing to the problem.

Now, let's discuss treatment options. Cortisone injections can help reduce inflammation in the facet joint and cyst, providing relief. Another option is the removal of the cyst, which can be skillfully performed through endoscopic spinal surgery or open surgery, depending on the case.

In cases where excessive motion is detected, fusion may be considered as a solution. However, in most instances, simply removing the cyst proves successful, offering over 90% positive results.

To sum it up, synovial cysts are relatively uncommon but can be diagnosed through MRI scans. They may be associated with instability and are often found at the L4-L5 level. Surgical treatments have shown high success rates, offering significant relief to those affected.

Thank you all for listening and being a part of this informative discussion. If you have any questions or concerns about synovial cysts or any other spinal conditions, please don't hesitate to reach out. Our team is here to provide you with expert guidance and personalized care for a healthier, pain-free spine. Stay well!

All Comments (21)
  • @edgoldman1827
    Thanks so much for the info. I just had an MRI and my pain specialist said I have multiple cysts with one large one pushing on the nerve. I’m going to have it drained and injection in the facet joint. I’m 63 and everything you explained helped in understanding this
  • @leeannfreeman
    Thank you, Doctor Mork, for explaining this condition so thoroughly. I have had this condition for some time and your presentation was a huge help to me as I face surgery to remove it next month.
  • Terrific video.  Crystal clear presentation which has helped me visualize what/where my diagnosed synovial cyst is and understand how it is impinging on the nerve(s) going to my legs.
  • @pepke84
    Thanks for this video! I was in a lot of pain two years ago. I had an MRI scan and it showed a disc bulge and a synovial cyst. The report said my pain was caused by the disc. I tried different treatments and nothing helped. I then decided to try IDD therapy and it worked wonders for me! I had a scan done after the treatment and it showed that the disc was still bulging a but the cyst was gone. I am glad I avoided surgery and can live a pain-free life again! I am 30 though so it shows you it can happen to people younger than 60. I just wasn't sure what that cyst exactly was but this video explained it really well. Thanks a million!
  • @allanseabrook
    Thank you, Dr Tony for the best explanation I have come across! Your clear and precise explanation has helped me immensely in understanding my condition and the treatment options.
  • I had mine removed when I was 45 but didn’t get significant relief until I had L4-L5 fused two weeks ago. Thanks for this video it’s very informative!!
  • @trixiegrl808
    I can't believe I'm only 37 yrs old and got this exact cyst and will have it surgically removed soon. A bit scared but it needs to be done. The pain is nuts! I feel it daily. Thank you so much for explaining this condition well. Blessings to you Dr.
  • @pottsofroses1
    Thank you for so much great information . You explain everything very well Dr Mark.
  • @lauraadkins6534
    Very helpful. Just had a large cyst removed and this is spot on
  • Thank you very much for your great explanation. I am having something like that, they pain is horribleeee!!! and usually don't let you sleep at night. Pain goes down to the right side, to the hip, the front, I never seen anything like it. I truly appreciate your time and wisdom, God bless you!
  • I'm much younger than 60 but my lower back, sciatic, and legs are killing me. My husband tried to massage my lower back but it hurt too badly for him to touch...he said it felt like I had a cyst. I thought that sounded crazy but then I googled it and it sounds like he may be correct. I hope it goes away on its own. I pray each person dealing with this pain gets relief.
  • I'm very happy that I came across this video as I have a support group for Tarlov (perineural) cyst disease sufferers and one of my members also has a Synovial cyst and needed some additional information. This video is perfect for her use. I have to wonder though since I see so many other cyst type treatment videos that you have done if you do any work on Tarlov Cysts as well. We are incredibly limited in the number of Neurosurgeons that work on symptomatic cysts, so any additional, available surgeons are an incredible asset.
  • Hi doctor thank you for the presentation I just had this done yesterday already feeling so much better. It's good to know we have you out there helping us layman 😁😊
  • @calebturley9284
    Thank you very much. I got the news today that I had a Synovial Cysts and this helped me so much to know what I am looking forward to going forward.
  • Thank you Dr. Mork, I had an MRI done and it shows that I do have synovial cysts - would this a symptom of my Foot Drop ? Originally the drop foot occurred from a broken spiral leg injury on the fibula near the knee. But an EMG ruled out nerve damage in the leg. I do not know how this could have resulted in the spine now. Any suggestions you might have would be helpful. Thank you for your informative video.
  • I have spent two days in hospital as I couldn't stand the pain of sciatica anymore. I have synovial cyst 5-8mm at L5S1. Was sent home with Sevredol and Gabapentin and 5days of oral steroids. I have no faith in this treatment however your video has given me aa great explanation of my problem and hope for a better approach if the steroids don't work. Wish I lived in the US- I'd be coming to see you. May actually be worth the trip over from NZ.  Thanks for the great Video
  • Dr. Mork, thanks for a clear easy-to-understand video. I have a synovial cyst at (where else) L4-L5 that is causing pain in my left leg. I have a consultation scheduled with a neurosurgeon but you've already answered my big question: Will I have to have spinal fusion? Good to know they can go back later and do the fusion if necessary. I just wanted to let you know your effort is much appreciated.
  • @foxfur8327
    My friend had synovial cyst in lumbar spine that was the worst pain for 90 days that no amount of opoids would help. After not moving in bed for 4 days solid and not eating for that long and urinating only in a bucket, the synovial cyst ruptured and pain disappeared, but before a year she couldn't walk one day so was in hospital for a few weeks on hydromorphine. After that she developed about 20 more cysts in her body. She already had some internal cysts as she was was prone to cysts and ganglions. Then she woke up with numb burning face on left side. Multiple new cysts were on back of head by hair line too but some were on stomach and butt and near pelvic bone. Doctors thought it was metastatic cancer from breast cancer several years ago because she also had pituitary macroadenoma, tested positive for Lyme disease and had 3 thyroid nodules. Didn't want biopsies. She is a senior who recently got crushed thoracic spine a couple of times as well as a few ribs a a couple of times within a 3 month period and then also got slipped disk in thoracic area. Doesn't know if face problem was caused by stroke or spine because no MRI available for several months. Has had regularly falling red and white platelets for last few years but iron level is ok (calcium level very high) even though she is pale as a ghost. Blood tests suggested no parathyroid problems. Now her spinal cyst is back again like a large boulder and she is developing more sciatica again and pain in inner upper thigh and vein on back of leg near knee. Has lot of pain and difficulty walking. Neurosurgeon says very high risk of death for removal of synovial cysts so not keen on operating. She lost over 100 pounds of muscle and fat in hospital 3 weeks when spinal nerve got pinched so is a little thin. Have you ever heard of a lumbar synovial cyst exploding twice? Also, have you heard of it creating multiple other cysts throughout the body after it bursts? Fears these cysts may be caused by spirochettes from the Lyme so there may be no options because cortisone can be deadly. Also fears second rupture will kill her. Also had ruptured hemorrhoid so seems to be dissolving or eaten from inside like the starfish on the coast of Vancouver and some ocean planktons in other parts of the world!
  • @32446
    I’m 43 and believe I have this. It’s ruining my life. Thankfully I have a scan booked for the end of the month. Praying for some answers.
  • @kiddshellac
    i have a large right facet synovial cyst at the L4-L5 level causing severe spinal stenosis. i'm interested in having it removed by the minimally invasive surgery (MIS) you've described. I'm on my butt most of the work day - between my commute and desk job - but I'm a weekend warrior with a list of chores and projects that keep me active during my time off. so I'm wondering how long after the MIS can I return to getting my life back? minus the pain, of course.