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Haemorrhage into juxta-facet cysts causing bilateral foot drop.
Journal of Surgical Case Reports
|June 25, 2014
Summary
A spinal synovial cyst caused severe back pain and foot drop in an elderly patient awaiting cancer surgery. Surgical intervention revealed a hemorrhagic juxta-articular cyst compressing the spinal canal.
Area of Science:
- Spinal Surgery
- Neurosurgery
- Oncology
Background:
- Elderly patients undergoing cancer surgery may present with neurological deficits.
- Spinal canal stenosis can result from various pathologies, including metastatic disease and cysts.
- Juxta-articular cysts are rare and can cause significant spinal cord compression.
Purpose of the Study:
- To report a case of a juxta-articular synovial cyst presenting as spinal canal stenosis in an elderly patient.
- To discuss the clinical presentation, diagnostic imaging, and surgical management of such cysts.
- To review the existing literature on juxta-articular cysts causing spinal cord compression.
Main Methods:
- Case presentation of an 89-year-old male with caecum carcinoma.
- Magnetic Resonance Imaging (MRI) to evaluate spinal pathology.
- Surgical exploration and histopathological examination of the cyst.
- Literature review on juxta-articular cysts.
Main Results:
- The patient presented with sudden back pain and subsequent foot drop.
- MRI identified spinal metastases and a cyst at L4/5 causing spinal canal stenosis.
- Surgery revealed a hemorrhagic juxta-articular synovial cyst.
- The cyst was surgically removed, relieving the compression.
Conclusions:
- Juxta-articular synovial cysts, though rare, should be considered in the differential diagnosis of spinal canal stenosis, especially in patients with neurological symptoms.
- Prompt diagnosis via MRI and surgical management are crucial for favorable outcomes.
- This case highlights the importance of considering unusual etiologies for spinal compression in elderly patients.
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