Complete Spontaneous Resolution of Lumbar Synovial Cyst: A Case Report and Systematic Literature Review

Since the natural course of lumbar synovial cyst (LSC) remains unclear, the optimal management of symptomatic LSC constitutes a controversial topic. While surgical removal is considered as the most efficient treatment method, cases of spontaneous resolution have also been reported. The purpose of the current paper was to discuss the pathophysiology and clinical features of the spontaneous resolution of LSC based on the current evidence and present an illustrative case report.

The literature search was performed across MEDLINE, Web of Science, and Scopus databases on 11th November 2024. Articles were only included if they described cases of spontaneous resolution of LSC without surgery. Descriptive statistics were used for the analysis of the data retrieved from eligible articles.

Twelve articles and the current report matched eligibility criteria, reporting 16 cases of spontaneous LSC resolution cumulatively. The mean age of the patients was 55.9±14.0 years. LSCs were most frequently reported in female patients (68.8%), at L4-L5 level (68.8%), and on the right side of the spinal canal (56.2%). The mean time between the symptomatic onset of LSCs and its spontaneous complete resolution was 10.7±6.8 months.

The current study supports a conservative management approach in selected patients with lumbar synovial cysts, highlighting the importance of follow-up before surgery is undertaken. Female gender and mild presenting symptoms might be factors predisposing to spontaneous resolution of LSC.