Surgical Management of a Cervical Synovial Cyst by Minimally Invasive Surgery: Case Report with a Technical Note

Background: Synovial cysts are most common in lumbar spine and are usually associated with degenerate facet joints. They are rare in cervical spine and less than 50 symptomatic cysts are reported in literature that were all treated by conventional open decompression either with or without fusion. Our objective was to report the surgical management of symptomatic cervical synovial cyst causing radiculo-myelopathic symptoms in an elderly gentleman treated by minimally invasive surgery.

Case Presentation: A seventy-nine-year-old gentleman presenting with three months history of progressively worsening right arm pain with myelopathic gait secondary to compression at C4-C5 caused by a synovial cyst that was treated by excision, decompression and unilateral lateral mass fixation by minimally invasive surgical approach. There was improvement in his gait and complete resolution of radiculopathy at six months postoperative follow-up visit. At five years post-op, he has remained symptom-free.

Conclusion: Excision of symptomatic CSCs can be safely performed by minimally invasive surgery technique as a day case procedure and was associated with complete resolution of neurological symptoms.

Keywords: Synovial cyst; Cervical spine; Lateral mass fixation; Minimally invasive surgery; Radiculopathy; Myelopathy