Spinal Juxta-Facet Cysts – Synovial and Ganglion Cysts

Synovial Cysts on MRI

The left image demonstrates 2 synovial cysts (white arrows) causing significant spinal stenosis (narrowing). The right sided image shows one of these cysts pressing on the nerves in a top-down (axial) view.

Spinal juxta-facet cysts are lesions associated with the spinal facet joints.  The facet joints connect each level of the spine, with one joint on the left and right.

Spinal juxta-facet cysts may also be called synovial cysts or ganglion cysts. They are not malignant (cancerous cysts).

When they press on the nerves of the spine, they can cause pain, numbness or weakness. They can sometimes rapidly increase in size because of bleeding in the cyst.

Treatments for Synovial Cysts

Synovial cysts are usually found when a patient has symptoms from nerve compression. A radiologist can try an injection into the cyst to burst it. Surgery is often recommended for cysts that are causing significant symptoms.

Simple removal of a cyst can be a minimally invasive surgery, with low risks and a quick recovery. However, there is a risk of the cyst growing back in a small number of cases. Sometimes fusion is recommended to stop the cyst growing back. However, this is a bigger operation with increased risks. The decision should be tailored to the patient’s individual condition.

Synovial Cyst Surgery

The upper left image (A) shows a synovial cyst found at surgery causing severe spinal stenosis (narrowing). The lower left image (B) shows good decompression of the spinal nerves after cyst removal. The cyst is seen in the right hand image (C).