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Ganglion Cyst of the Spine

From: BJ - on 03/10/2010 12:55am

I have been disgnosed with a ganglion cyst in my spine at L5-S1 that has encroached the nerve root. I have already had 2 epidural injections and am scheduled for the third in 3 weeks. I am in Pain Management, physical therapy and taking medication to help control the pain. My pain became intolerable very quickly. I felt as though some one was slicing my leg with a knife from my hip down into and around my foot. I was unable to lay, sit or put any weight on my leg. It was the worst pain I have ever had in my life. After I had the MRI done, I was seen by a neurosurgeon, bless his heart, he has patients on a waiting list to see him but he triaged me into his first available appointment. He says to finish the third epidural and if i have any pain return, i should call him and he will schedule surgery. I have an appointment in April for a second opinion with a Neurosurgeon at a teaching hospital who has a lot of experience with cyst/tumors etc. I have tried to find information on Ganglion Cysts of the spine but there is not much information available. Most articles that I have read say that this is not a common condition, and most all of them suggest the best cure is surgery to remove the ganglion cyst. Does anyone have any information to share with me about these cysts?

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on 03/11/2010 11:44pm

Another name for the cyst is facet joint cyst. My doctor said it is the same as a ganglion cyst on the wrist. I went through four epidurals on a year period before I finally had mine removed at the end of January. The surgeon said I should have had it removed sooner. You might want to get a second opinion from a orthopedic surgeon who specialies in the lower spine. As long as they are only removing the cyst you should have a full recovery in about 8 weeks. I am doing physical therapy for three weeks to help with recovery.

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on 03/12/2010 12:53am

Ganglion cyst is synonymous and one in the same with synovial cyst. I had this type of cyst removed at C2-C3 (almost 2 years ago). My pain, like you describe, came on very quick and was very intense. From what I understand the cyst will not resolve on it's own and needs to be surgically removed.

I'd recommend you do an internet search on the term synovial cyst.

Best wishes

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on 03/18/2010 6:10pm

Hello, I have experienced a cyst on my spinal cord in 1998. It was removed then 6 months later, I had another one on the other side. Went back to work; doing good then the pain came back. My neurosurgeon, and she did a fusion L-4 L-5, after that I could not work anymore because of my job was to work in physical and occupationl therapy. I develeped spondololisthesis. She said that I would only have a 50% chance it would work...so I decided I would not go that route; she then sent me to a pain specialist. He has been working with me ever since. I have had tens unit, other units that was supposed to help with the pain; nothing helped so we went to injections, pain pump which helped some. But now; My Doc finally found something that helped me. I have some type of radiofrequency procedure. The problem is it don't last over 2 months and the Doc. expected it to last 6 months or more. Hope this helps, Pat

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on 03/21/2010 1:12pm

OK - here goes my take on my own ugly back. The synovial cyst that I have is at the L4-L5 level which is severely narrowing the central canal and compressing the adjacent nerve root. Also, multilevel lumbar spondylosis with smaill disc herniations at L1-L2, L3-L4 and L5-S1. Several Schmorl's nodes are also noted. The homework that I've done suggests that the snovial cyst must be removed with a spinal fusion from L5 to S-1 for complete relief and reoccurance to be almost eliminated completely. I'm searching for the minimally invasive surgery and found one in California and the Rothman Institute. I'm waiting to hear from them both to see which is going to provide the best options for me. I'm a cancer survior of 18 years - I had anal cancer treated with chemo and radiation. http://www.medcyclopaedia.com/library/topics/volume_iii_1/s/synovial_cyst.aspx is a good link to read. lots of information on the web - just need a medical dictionary and lots of time!

I'm always looking for good information, so please let me know if anyone else has some insight.

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on 03/29/2010 3:04pm

Hi I have had the same condition at L4L5 and have suffered the same intolerable pain for 2 yrs. I was first sent away from my GP with a prescription for Ibuprofen for arthritis but I knew better than him it was something more. After several MRIs etc I was properly diagnosed with an intraspinal ganglion/synovial cyst.
I was told that only surgery would resolve the problem and after many delays/waits provided by our glorious NHS I had a 'Bilateral decompression and removal of Cyst'. As soon as I woke I knew the prob had been solved even through the pain and wound of the op. 1 week after surgery I walked a beautiful mile in sunshine. I couldnt do 10 yds without excruciating pain before. I have definitely had a good result and would recommend this as a solution for you even though there are always risks with any kind of spinal op.
One month down the line I have no pain and walk freely even tho my legs need some strengthening after a couple years low level activity. I wish you good luck with your future endeavour and hope you get your life back as this stuff surely takes it away from you. Take care, and please feel free to ask any questions.

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on 08/13/2010 6:27am

I have recently been diagnosed with synovial cyst at L4-5 with degenerative disc disease and a "curvilinear focus of T2hyperintensity along the posterior disc margin compatible with annualr tear". The tumor is described as projecting from the right facet joint into the spinal canal. And it goes on... At L5-S1, there is degenerative disc disease with annular tear.
Like you guys my pain became very quickly more than I could handle, but if my husband hadn't nagged me about it I probably still wouldn't have gone to the doctor because I have been in constant pain for years because of the herniation at L5-S1 and I just thought it was the same song, different verse. Thank you, sweetie! He's a good guy.
Anyway, the gist of my research is that surgery is the only really effective treatment. To that end, I am trying to find the best surgeon with the best team. Any suggestions?

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on 08/14/2010 1:56pm

I've come a long, long way since I posted on this website. Dr. Todd Albert from the Rothman Institute performed my spinal fusion L-3 L-4 & L-5 (2 rods & 6 screws), removed the synovial cyst (the size of a large grape) between S-1 L-5 and performed a lamectomy (removes all the spikes and crumbs from deteriorated bone) on 5/3/2010. Two months after I my surgery, I felt well enough to go back to work part-time so I could build my stamina and continuing my physical therapy 3-times a week. I'm back to work full-time and I've gone on a 10-day vacation. I've got my life back because of Dr. Albert and his team of experts!!!
The information that I found regarding synovial cysts - just copy the link below into your browser - it's very compelling research which led me to my doc and the decisions I needed to make. Here is the website: http://www.medcyclopaedia.com/library/topics/volume_iii_1/s/synovial_cyst.aspx
I hope it helps you find a solution to a very painful situation!!

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on 03/18/2011 10:40am

BJ, i feel your pain (no pun intended). After 9 months of increasing pain, doctors, conservative treatments, an MRI and one epidural shot, I resorted to surgery, which I had just 9 days ago. The first neurosurgeon I saw said I had a synovial cyst with mild spondylolisthesis and strongly suggested removing the cyst and having spinal fusion at L4-5. My second opinion doc thought a minimally invasive approach to cyst removal would be fine. I went with him. After surgery he said the cyst "cooperated" with respect to removal but that it did not look like a typical synovial cyst. Indeed, pathology showed it was a ganglion cyst. So, synovial and ganglion cysts are similar but not exactly the same thing. From the webMD site: "Although there are histological differences between synovial and ganglion cysts, their treatment and prognosis are identical. That is why they are grouped together as juxtafacet cysts, but in practice it is common for physicians to refer to both entities as synovial cysts." And from a Korean med source: "In terms of surgical strategy, instrumentation has been frequently required for the synovial cysts because of wide excision of the facet joint and preexisting instability14,18). However, the ganglion cysts have no correlation with segmental instability and connection to facet joints. Therefore, simple excision of the ganglion cyst could be successful through minimal access1,10,15,19)." Keep searching the Web. There is more info out there.
At any rate, I am pleased with my choice and outcome of surgery. Wishing you the same.

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on 03/21/2012 3:04am

Back in '08, I felt great pain in my lower back and sciatica (right leg) to the point where I could not stand even for a minute without screaming in pain. Basic chores, like shopping or washing dishes, was impossible. I begged my doctor for an MRI but he felt that pain meds and bed rest would be better. This went on for months. When the pain meds stopped working (sooner rather than later), I took a taxi to an emergency room where they immediately gave me an MRI. I had a synovial cyst at L4/L5 and surgery was scheduled immediately. I remained in the hospital for almost a week and basically had to re-learn how to walk. The entire experience was painful, but I was happy that I had it removed. I was guaranteed that there would be no further recurrence of it, and I would have a complete recovery. NOT!!! In 2010, the pain returned. I was terrified. Was it back? Was it cancer now? It was worse than before. As a Disabled Veteran (for an unrelated disability), I went to the VA and begged them to give me an MRI. It was as though I was asking for the keys to the city because it took an act of God to get them to do this (months later). Now, I had herniated discs, but no tumor. Okay, no tumor! Herniated discs??? I got 3 epidural shots.They didn't help. I finally sought out a civilian neurologist/pain management specialist. He did a complete work-up. While the cyst did not recur, my lower back pain, sciatica and (new) painful leg cramps have gotten much worse. Apparently what everyone else missed was that my S1 nerve is completely dead in addition to L4/L5 damaged. So, after much thought, I decided to have an electrical stimulation system placed inside my body (hip). I use an external tens unit to control the internal electrode unit. I use the external unit to increase/decrease the stimulation which also helps with my sciatica. My surgeon also arranged the internal electrodes to assist when my left sciatica begins to hurt. While this is not a cure-all, it does help. Unfortunately, I will have to remain on pain meds the rest of my life as well. I apologize for going on as long as I have, but I thought sharing my entire story would be helpful to anyone out there suffering as I have and currently am. I do have more info about these cysts. Let me know if I can be of more help.

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on 06/16/2012 5:11pm

I had an mri in 09 were they said I had a gangilan cyst but was of no consequence at the time i was 10 cm which i don't how big that is. but in the last few weeks it has been very painful. Could this be the cyst?

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on 03/14/2013 3:07pm

I had this condition and had surgery February 2011, I missed all of 6 days of work ( i have a desk job)no physical therapy or any injections. My surgery was done by an Orthopedic Surgeon in Nashville, TN, and at an out patient facility. I have not had any problems since, my cyst was in my lower back area around the L5. I called a Neurosurgeon that I knew and he said you need an Orthopedic Surgeon that specializes in backs and that is where I went. Dr. Melvin Law, Centennial Hospital Nashville, TN. He is the best, I suggest you skip the Neurosurgeon and go straight to the Orthopedic. Don't delay, the longer you wait the bigger they get and the tentcales will wrap around the spinnal cord and make the surgery more complicated.

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