{"id":"d2fe1e43-99ce-4ecf-a654-f0baf3b80fd1","slug":"intradural-synovial-cyst-of-the-upper-cervical-spine-a-rare-cause-of-symptomatic-cord-compression","title":"Intradural synovial cyst of the upper cervical spine: A rare cause of symptomatic cord compression","authors":["Yahya H. Khormi","Ryan Chrenek","Tejas Sankar"],"abstract":"Background: Synovial cysts are commonly observed soft-tissue masses of the spine, typically extradural and located in the lumbar region. We describe a very rare symptomatic case of a C1-C2 intradural synovial cyst. Case Description: A 78-year-old female presented with progressive left side weakness, paresthesia, and hyperreflexia. The magnetic resonance imaging revealed a well-circumscribed, subtly enhancing lesion medial to the C1-2 facet, causing cord compression and edema. Using neurophysiological monitoring, surgery included a modified laminectomy of C2 with the removal of the C1 posterior arch. When the dura was opened, a sizable intradural extramedullary lesion was encountered, the cyst was successfully drained and partially resected. The histopathological diagnosis was consistent with a synovial cyst. Postoperatively, the patient’s strength on the left side improved gradually until she was fully ambulatory. Postoperative imaging showed no recurrence at 8 months follow-up. Conclusion: Synovial cysts should be considered among the differential diagnose of C1-2 cysts. They can occur intradurally and compress the spinal cord resulting in a significant neurological deficit. Cyst excision may be accomplished utilizing a limited laminectomy for cyst identification and drainage, accompanied by partial resection of the cyst wall. Such intervention can lead to good clinical outcomes.","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/articles/d2fe1e43-99ce-4ecf-a654-f0baf3b80fd1/featured/hero-1781563322796.png","publishDate":"2020-07-11T00:00:00.000Z","doi":"10.25259/SNI_355_2020","categories":["Spine","Case Report"],"fullTextUrl":"https://surgicalneurologyint.com/wp-content/uploads/2020/07/10132/SNI-11-190.pdf"}