Doctors from Seoul, Korea present an unusual case of synovial cyst in the spine. Cysts of this type are usually located in the hand or wrist. Synovial fluid from the joint leaks out and forms a pouch or cyst. Synovial cysts are different from ganglion cysts because the synovial cyst has a synovial lining.
In this case a 56-year-old woman with a 15 year history of severe pain down both legs (radiculopathy) was treated with surgery for a synovial cyst. The cyst was identified on MRI. During the operation the surgeons could see the cyst was wrapped around the nerve root like a wedding ring.
The surgeons removed part of the bone (laminectomy) and removed the facet joints on both sides. The cyst was removed. It was separate from the facet joint next to it and pressing on the L45 nerve root. A synovial cyst without a link or opening to the facet joint is a rare but possible cause of radiculopathy from nerve root compression.