A cyst is a fluid-filled sac that can develop in the spine as a result of degeneration and can lead to spinal stenosis or other painful, serious conditions.
There are several different types of cysts that may develop within the spinal cord, although synovial cysts are most common. Synovial cysts develop within the facet joints as cartilage wears away and excess fluid is produced within the joint. The excess fluid is retained within synovium of the joint and forms a cyst. Other types of spinal cysts include arachnoid cysts, Tarlov cysts, extramedullary cysts and many more.
Patients with a spinal cyst may not experience any symptoms if the cyst remains small and stable. As the cyst progresses and becomes more severe, it may cause pain in the back that travels down the legs as well, and can also lead to spinal stenosis, which may cause pain, cramping and numbness.
Spinal cysts tend to cause pain in certain positions, such as while standing or remaining still for prolonged periods of time. Many patients can reduce the severity of their symptoms by frequently changing positions or by adjusting their activities to remain in a seated position more often.
Cysts that do not cause symptoms and do not seem to be growing at a rapid rate may not require any treatment other than regular monitoring of the condition. Patients that experience pain from their cyst may benefit from facet or epidural steroid injections that decrease inflammation and temporarily relieve pain. In some cases, the cyst may be joined through the same needle used for facet injections.
Cysts that cause significant pain and are growing in size may require surgery to effectively remove the cyst and prevent serious complications from occurring. Surgery to treat spinal cysts most commonly involves decompression with or without spine fusion surgery. This involves removing the cyst and then fusing the joint together to prevent the cyst from regenerating. Surgery is usually reserved for patients who wish to participate in physical activities with less pain.
It is important for patients to consider their treatment options by evaluating their own pain and discussing their options with an experienced doctor.
Spinal stenosis is a common condition that involves a narrowing in one or more areas of the spine as a result of injury or deterioration to the discs, joints or bones within the spinal canal.
While some patients may be born with spinal stenosis, most cases develop later in life as a result of the degenerative changes that occur in the spine over time. Osteoarthritis is the main cause of spinal stenosis, as it causes the cartilage in the area to deteriorate and eventually results in the bones rubbing against each other and forming growths called bone spurs. These bone spurs may narrow the spinal canal when they form the facet joints. Spinal stenosis can also be caused by a herniated disc, ligament changes or spinal tumors.
Patients with spinal stenosis may experience cramping, pain and numbness in the legs, back, neck, shoulders or arms, depending on which part of the spine is affected. A loss of sensation, loss of balance and bladder malfunctioning may also occur in some patients.
Some patients may not experience any symptoms from this condition. It is only when the narrowed area of the spine compresses the spinal cord or nerves that symptoms arise.
Spinal stenosis is often difficult to diagnose because its symptoms can come and go and may resemble the symptoms of many other conditions. A diagnosis of spinal stenosis is often achieved after ruling out other conditions after performing imaging exams such as a spinal X-ray, MRI, CT scan, bone scan and others. Your doctor will also ask you several questions about your symptoms and overall health to correctly diagnose your condition and provide an adequate treatment solution.
Most cases of spinal stenosis can be effectively treated through conservative methods such as physical therapy, nonsteroidal anti-inflammatory drugs, rest and a back brace. These treatments are usually administered for at least three months for the spine to heal properly and allow for full function. The specific treatment for your individual condition may vary.
For more severe cases of spinal stenosis, surgery may be required to relieve pressure on the spinal cord while also maintaining the integrity of the site. This may be achieved through procedures such as a decompressive laminectomy, laminotomy or fusion that relieve pressure and join the damaged bone back to its normal state.
Specialties - Neurosurgery