Synovial excrescences and cysts of the spine

Clinicopathological features and contributions to spinal stenosis

Chun-I Sze, G. Kindt, W. B. Huffer, M. Chang, M. Wang, B. K. Kleinschmidt-DeMasters

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Synovial cysts occur throughout the body and are generally benign lesions with limited clinical consequences. Juxtafacet cysts of the spine, in contrast, often press on a nerve root as it exits in the foramen, causing radiculopathy. Synovial tissue that emanates from the facet joint but extends medially, is an additional important cause of spinal stenosis. Over the past 5 years, neurosurgeons at our institution have operated on a large number of patients with back pain, with removal of abnormal synovial tissues. Histological examination of these tissues distinguishes the different types of pathologic processes responsible for producing symptoms. Juxtafacet cysts may be either mucin-filled ganglion cysts devoid of cyst lining or true synovial cysts with watery content and lined by synovial cells. Ganglion cysts arise in degenerated ligament at the facet joint, and occasionally within synovial stroma. Synovial cysts arise within synovium and, unlike synovial cysts in the extremities, have a thick wall containing granulation tissue, numerous histiocytes and giant cells. This hyperplastic, irritated synovium of the spine, which we term "synovial excrescences", is voluminous and this reactive part overshadows the cystic portion of the lesion in most instances. Iron pigment deposition and inflammation are mild to absent, making synovial excrescences different from pigmented villonodular synovitis. Synovial excrescences of the spine are an important cause of spinal stenosis, predominantly in elderly patients. Surgical removal of excrescences protruding into the spinal canal provides prompt and durable relief of symptoms, usually without the need for extensive bony laminectomy or spinal fusion. Several patients in our study had both spinal ganglion cysts and synovial excrescences, suggesting common risk factors for both lesions.

Original languageEnglish
Pages (from-to)80-90
Number of pages11
JournalClinical Neuropathology
Volume23
Issue number2
Publication statusPublished - 2004 Mar 1

Fingerprint

Synovial Cyst
Spinal Stenosis
Ganglion Cysts
Spine
Zygapophyseal Joint
Cysts
Synovial Membrane
Pigmented Villonodular Synovitis
Spinal Fusion
Radiculopathy
Spinal Canal
Histiocytes
Laminectomy
Granulation Tissue
Spinal Ganglia
Mucins
Pathologic Processes
Giant Cells
Back Pain
Ligaments

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine
  • Neurology
  • Clinical Neurology

Cite this

Sze, C-I., Kindt, G., Huffer, W. B., Chang, M., Wang, M., & Kleinschmidt-DeMasters, B. K. (2004). Synovial excrescences and cysts of the spine: Clinicopathological features and contributions to spinal stenosis. Clinical Neuropathology, 23(2), 80-90.
Sze, Chun-I ; Kindt, G. ; Huffer, W. B. ; Chang, M. ; Wang, M. ; Kleinschmidt-DeMasters, B. K. / Synovial excrescences and cysts of the spine : Clinicopathological features and contributions to spinal stenosis. In: Clinical Neuropathology. 2004 ; Vol. 23, No. 2. pp. 80-90.
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Sze, C-I, Kindt, G, Huffer, WB, Chang, M, Wang, M & Kleinschmidt-DeMasters, BK 2004, 'Synovial excrescences and cysts of the spine: Clinicopathological features and contributions to spinal stenosis', Clinical Neuropathology, vol. 23, no. 2, pp. 80-90.

Synovial excrescences and cysts of the spine : Clinicopathological features and contributions to spinal stenosis. / Sze, Chun-I; Kindt, G.; Huffer, W. B.; Chang, M.; Wang, M.; Kleinschmidt-DeMasters, B. K.

In: Clinical Neuropathology, Vol. 23, No. 2, 01.03.2004, p. 80-90.

Research output: Contribution to journalArticle

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