Fluid-filled sacs known as cysts can appear almost anywhere on or within the body. Some cysts go unnoticed, while others produce symptoms such as persistent pain. When growths like this occur in the spine, they are known as synovial cysts. Sometimes producing a consistent level of discomfort for several years, these growths are benign (non-cancerous). However, synovial cysts may cause recurring pain that’s distracting enough to require treatment beyond typical conservative solutions such as hot and cold therapy, rest, and anti-inflammatory medications. Here are three ways to treat spinal cysts that aren’t responding well to traditional remedies.
1. Physical Modifications
Patient-specific physical adjustments or modifications are usually recommended after image testing is performed to identify where the cyst is located and what’s likely to take pressure off nerve roots. The following physical modifications may be paired with traditional treatments like low-impact aerobic exercises* and stretching techniques:
- Improvements with posture
- Spinal adjustments or manipulations
- Shoe inserts to shift spinal alignment
*Since seated positions are often more comfortable for patients with pain from spinal cysts, a stationary bike may be a better choice for aerobic exercise than walking.
2. Epidural Steroid Injections
Synovial cysts sometimes irritate nearby tissues enough to cause swelling in the immediate area where the cyst is located. Epidural steroid injections placed directly into the affected area may ease inflammation enough to provide relief.
A related procedure also involving a needle may be performed to drain the cyst. Drainage can also be achieved with a facet injection. A small needle is placed into the facet joint to drain the fluid from the cyst by aspirating it. Following drainage, steroid medication is injected to reduce inflammation.
Epidural injections are often temporary solutions that work about 50 percent of the time, according to some estimates, since the underlying source of the cyst isn’t being treated. Even cyst drainage may only provide temporary relief if the conditions that caused the cyst to develop still exist.
3. Spine Surgery
If cysts continue to produce pain or come back following drainage, surgery may become an option. Two common procedures are often recommended. If removing the cyst won’t make the spine unstable, microdecompression spine surgery is a minimally invasive operation that may provide relief. For situations where it may make sense to prevent movement in the affected area, decompression with fusion may be suggested to stabilize the spine. Fusion often minimizes the risk of cysts coming back by limiting movement.
More common in older patients, spinal cysts usually develop in the lower spine in the L4-L5 level. These fluid-filled sacs may form due to excessive friction affecting adjacent vertebrae. Synovial cysts can also develop due to trauma, degeneration of facet joints, a vertebra slipping forward over an adjacent one (spondylolisthesis), or unrelated spinal conditions like scoliosis. A common sign of a spinal cyst is pain that goes away when seated since this is when the spinal canal widens. If neurological symptoms that include numbness and tingling sensations are experienced, it’s important to meet with a Santa Monica spine surgeon to get a positive diagnosis and explore treatment options.
At The Spine Institute, Dr. Hyun Bae and his team of expert surgeons can diagnose your condition and determine an effective solution to help you find relief. Some spinal conditions require surgery ranging from spinal decompression to anterior lumbar interbody fusion. Santa Monica patients can call 310-828-7757 to schedule an in-person evaluation.