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A lumbar synovial cyst is a sac filled with fluid that forms in the lower section of the spinal column. Most of these growths form due to the breakdown of a facet joint, which is part of a vertebral bone. Synovial cysts are not cancerous and are often stable for years. In rare instances, if a cyst grows too large it can trigger spinal stenosis. Lumbar synovial cysts tend to develop later in life and often occur in individuals aged 45 and older, with no increased prevalence linked to gender.

The symptoms of a lumbar synovial cyst are:

  • Pain in one or both legs that may move down to the foot
  • Pain when walking or standing straight
  • Muscle weakness including foot drop, numbness, and tingling in one or both legs
  • Cramping, painful feelings in the legs
  • Low back pain

The causes of a lumbar synovial cyst are due to facet joint deterioration. Cysts most frequently develop at the L4-L5 vertebral level because this is the area in which most facet joint degeneration occurs.

The synovium is a fine layer of material that produces fluid to keep the facet joint lubricated. When the joint breaks down, the synovium compensates by making more fluid to help keep the joint functioning properly.

Lumbar synovial cysts are diagnosed using an MRI. X-rays are also used to help the physician determine if there is any occurrence of spinal instability, as degenerative spondylolisthesis can often be present with facet joint degeneration.

Conservative treatment for lumbar synovial cysts begins with observation and activity modification. If the individual is experiencing pain, relief may come with hot and cold therapy, pain medications, and brief periods of rest. Exercise and stretching, along with facet or epidural injections, are also included in most nonsurgical treatment protocols. If surgery is required, microdecompression and decompression with spinal fusion are the preferred choices.

If you are suffering from unresolved low back pain and would like to talk with one of our physicians about treatment options, please contact our New Braunfels or Seguin offices.

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