A Rare T2-T3 Synovial Facet Cyst Causing Progressive Myelopathy

July 27, 2021

Case Reports

. 2021 Jun 29;2021:2799749.

doi: 10.1155/2021/2799749.

eCollection 2021.

Affiliations

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Case Reports

Mohamed F Albana et al.

Case Rep Orthop.

2021.

Abstract

Intraspinal extradural synovial cysts are a rare occurrence at the spinal cord level and thus a rare cause of myelopathy. Synovial cysts usually present in the more mobile lumbar and cervical parts of the spine; however, they may also arise in the thoracic spine. We present a case of a 59-year-old male with a left upper thoracic synovial cyst at T2-3 causing disabling, progressive myelopathy, and an incomplete spinal cord injury syndrome with inability to ambulate. An urgent decompressive laminectomy with bilateral facetectomies, cyst excision, and posterior fusion was performed. Subsequently, the patient recovered full function. Synovial cysts should be considered in the differential diagnosis of progressive thoracic myelopathy. This is only the sixth reported case of a synovial cyst of this kind occurring between the levels of T1 and T7. Urgent surgical decompression is the recommended treatment.

Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

**Figure 1**

(a) Axial T1-weighted MRI, (b) sagittal T1-weighted MRI, and (c) sagittal T2-weighted and short tau inverted recover MRI images demonstrating a large left T2-T3 synovial facet cyst within the spinal canal.

**Figure 2**

Microscopic image showing denuded cyst lining with focal synovium present. Gross specimen size 4.0 × 1.3 × 0.5 cm.

**Figure 3**

Sagittal, precontrast (a) and postcontrast (b), and axial postcontrast (c) MRI sequences 3 months postoperatively demonstrating maintained surgical decompression and no recurrent cyst formation.

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