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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!