Perspective: Operate on Lumbar Synovial Cysts and Avoid Ineffective Percutaneous Techniques-Part 1; Dr. Nancy Epstein

SUMMARY: Dr. Epstein presents a brief lecture with discussion on the subject of Lumbar Synovial Cysts of the Spine. She discusses the origin from the facet joint as an extruded cyst formation. The detailed pathology appearance from a cyst structure to a fibrous often calcified walled vesicle that presses on the related cauda equina centrally and spinal nerve roots laterally is described. A detailed series of images shows the cyst appearance on CT, MR , and myelographic imaging. The pathology is clear indicating the difficulty in treating this lesion with needle aspiration, a procedure itself which can produce dural tears, scarring, and root damage,  as substantial risks in addition to a high chance of failure on aspiration of the cyst's crankcase thick oil base contents, if even existent. Based on this evidence, the basis for aspiration of these cysts seems unfounded. This background supports the  logical surgical treatment of this disease, which itself requires excellent surgical skills and judgement and attention to the principles of spine surgery, which are covered in Part 2 of this talk and discussion. A very clear presentation of the pathology, method of diagnosis, and clinical picture of synovial cysts.


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Moderator / Speaker
  • James I. Ausman, MD, MA, PhD

    CEO SNI and SNI Digital; Emeritus Professor Neurosurgery

James I. and Carolyn R. Educational Foundation

  • Nancy Epstein, MD

    Chief, Neurosurgical Spine and Education, Winthrop Univesrit...

Neurosurgeon, Spine Neurosurgery, Professor of Clinical Neurosurgery, School of Medicine, State Univ...