Spine Disorders
SIGNS AND SYMPTOMS A facet
cyst can develop without any associated symptoms. Very often the cyst is
discovered incidentally on advanced imaging studies such as CT or MRI, ordered
for the investigation of spinal pain or neurological symptoms. The mere
presence of a facet cyst does not confirm that it is the sole cause of pain or
symptoms that the patient is reporting. There may be a coexistent problem at
the same spinal segment. A good example would be a herniated disc and synovial
cyst found at the same level in the spine. The source of pain in this example
may be attributable to herniated disc rather than the synovial cyst. The most
common symptom associated with a facet joint synovial cyst is recurrent or
persistent low back pain. The low back pain is often magnified in certain
positions or with movement. A large facet synovial cyst can cause compression
of adjacent neurological structure producing neurological signs and symptoms. Neurological
signs and symptoms include:
CAUSES The
synovium is a thin film of tissue that produces fluid (synovial fluid) which,
helps lubricate the joints. Degeneration of spinal facet joints can lead to a
build up of synovial fluid pressure within the joint. The increased pressure
can lead to escape of some of the fluid from the joint capsule, creating a
sac-like protrusion, referred to as a synovial cyst. Any
condition which places the facet joint under enough strain or stress to injure
supporting elements may contribute to the development of degenerative changes
over time. This may lead to the development of a cyst. Potential causes
include:
RISK FACTORS The
presence of two or more risk factors increases the likelihood of developing a
degenerative spinal facet joint cyst. Risk factors for the development of a
facet joint cyst include:
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