Surgery to remove a spinal cyst is considered the only effective method of treatment in advanced stages of the disease when it comes to periarticular synovial cyst
intervertebral facet joint. Typically, this condition is accompanied by pain in the arm or leg, sometimes with numbness. In some medical cases, the pain can be so unbearable that the patient may require emergency spinal surgery.
Cyst of intervertebral (facet) joints
- a benign formation in the cavity of which fluid accumulates. Over time, it increases in size and causes severe pain. Experts classify spinal cysts as rare pathologies, but recommend not to let the disease progress and to promptly seek help from neurosurgeons if symptoms are present.
Symptoms of a spinal cyst
Depending on the location, spinal cysts can be divided into:
- Cysts in the cervical spine;
- Cysts in the thoracic spine;
- Cysts in the lumbar spine;
- Cysts in the lumbosacral spine;
- Cysts in the sacral spine.
According to the nature of education, experts distinguish the following types:
- Perineural cyst of the spine (usually an incidental finding and does not require treatment)
- Paraarticular cyst (paraarticular synovial cyst of the intervertebral facet joint, requires spinal surgery)
- Arachnoid cyst (extremely rare)
As experts note, there are dozens of types of spinal cysts, most of which are considered normal
.
Surgical treatment is indicated for paraarticular synovial cyst of the intervertebral facet joint if radicular compression symptoms are observed.
In practice, this means that the patient suffers from regular pain in the area where the cyst is located in the spine and in the limbs. Often the discomfort is accompanied by numbness in the arm or leg. If the pain becomes unbearable, emergency surgery is recommended.
Diagnostics
Diagnosis of cysts is aimed primarily at their differentiation from other space-occupying formations of the spine - benign and malignant tumors, herniated intervertebral discs. Additional examination methods can resolve these issues, as well as assess the prospects for conservative and surgical treatment. Based on the results of a neurological examination, the following is prescribed:
- magnetic resonance imaging;
- computed tomography;
- ultrasonography;
- radioisotope scanning (scintigraphy);
- myelography - x-ray examination with subarachnoid injection of a contrast agent into the spinal canal;
- biopsy – in diagnostically difficult cases in order to obtain material for cytological and histological examination.
Surgeries for spinal cysts
As already mentioned, most often surgical intervention is indicated for paraarticular synovial cyst of the intervertebral facet joint. Many patients consider laser removal of spinal cysts to be the most effective method, but neurosurgeons deny the effectiveness of such an operation. When removing a spinal cyst with a laser, the heat wave negatively affects the spinal discs, destroying them. Therefore, it has already been experimentally proven that the method of removing spinal cysts with a laser is noticeably outdated.
Treatment of perineural cysts
After identifying the presence of a cyst, the doctor, based on its size, location parameters, age of formation and etiology, prescribes either therapeutic or surgical treatment.
Advice. If the formation does not exceed one and a half centimeters in diameter, a medicinal component is not always necessary. In other cases, if there is no impact on the nerve endings and there is no pain, the patient will be offered regular monitoring to control the size of the formation and the degree of its impact on surrounding tissues.
Conservative therapy
If the cyst grows and reaches two centimeters in diameter or more, conservative therapy is used. Its goal is to relieve the existing pain syndrome, which is intended to improve the patient’s quality of life.
By the way. Drug therapy is prescribed to relieve pain and inflammation, but it is impossible to completely remove the cyst with painkillers and anti-inflammatory drugs.
Table. Methods of conservative treatment
| Way | Description | Image |
| Drug therapy for pain relief | For therapeutic drug effects, primarily non-steroidal drugs are used. 1. Nise. 2. Movalis. 3. Diclofenac. The medications are indicated for oral administration, but may be prescribed in other forms, especially for patients with gastrointestinal problems. Medicines can reduce pain until it disappears | Nise |
| Muscle relaxant drugs | In addition to non-steroids, in parallel with them, muscle relaxants are prescribed, the most prominent representative of which is Mydocalm. This drug relieves muscle spasm, which often accompanies the growth of a perineural cyst. | Mydocalm |
| Nootropic drugs | Nootropics, also called neurometabolic agents, stabilize the central nervous system, improving its processes, have an antioxidant effect, exhibit antihypoxic properties, and increase the stability of nerve cells. The most famous drug of the group is Piracetam. | Piracetam |
| Vasoactive drugs | To speed up blood flow and help improve the morphological condition of nerve tissue, patients are prescribed the vasoactive drug Pentoxifylline |
|
| Fatty acid | A number of essential fatty acids that make up the fish oil formula have the ability to accelerate the healing of damaged cells by activating the immune response |
|
| Vitamins | Almost always, for additional fortification, a vitamin from the B-group is prescribed in the form of intramuscular injections |
|
| Physiotherapy | Physiotherapeutic procedures, magnetic therapy, ultraviolet radiation are prescribed in order to slow down the growth of the cyst. Also, after completing a course of medications, a massage course is prescribed. |
|
Advice. With conservative non-surgical treatment, physical activity must be limited, recommendations for taking medications are strictly followed, and at the end of the treatment, massage and physiotherapeutic procedures are performed.
Surgical treatment
If the cyst vesicle grows and reaches two centimeters in diameter, with an inadequate or weak response to drug therapy for a long time, surgical intervention is indicated.
Important! Before making a decision about surgery, a thorough study of the “behavior” of the cyst over a certain time is carried out, its growth is recorded, analyzed and predicted. All post-operative consequences for the body must also be provided for.
The surgical intervention takes the form of an ultrasound-controlled puncture, during which fluid is removed from the cyst vesicle, and a drug is injected into the vesicle (emptied) to promote the fusion of its walls. In this way, the cyst can be completely destroyed. Everything happens under local anesthesia.
Methods of surgical treatment
By the way. The operation is preceded by therapy that strengthens the immune system. After the intervention, rehabilitation measures are carried out.
Despite the fact that the operation to destroy a perineural cyst is not considered difficult, it can cause serious complications, which include:
- postoperative meningitis is the most common complication, which can lead to consequences including disability;
- hypotension of cerebrospinal fluid;
- spinal cord injuries and injuries.
Therefore, surgery is resorted to only when it is impossible to cope with the cyst conservatively, its growth is too rapid, and the formation itself pathologically affects systems and organs.
Important! A cyst in the spine cannot be treated with folk remedies. You can resort to auxiliary herbal therapy in order to boost immunity, enhance the anti-inflammatory and analgesic effect and increase the body's defenses.
Video - Coccyx cyst
Possible consequences
If the cyst is small and its growth does not progress, it can remain in the spine for years without showing symptoms. This does not pose a risk to human health. But with a decrease in immunity or activation of the inflammatory process, the formation also becomes active, begins to increase and leads to the appearance of pain and other symptoms, signaling that it is necessary to begin treatment.
At first, the cyst pinches the nerve endings as the cyst-shaped cavity grows and “swells.” Cellular metabolism is then disrupted, causing tissue hypoxia. Tissue degeneration occurs, acute pain appears, and dysfunction of the limbs and organs appears.
Important! A cyst of the sacral zone is not considered a dangerous pathology until it begins to grow and threaten the normal functioning of other organs, but if it grows uncontrolled and timely medical care is not provided, musculoskeletal disorders are possible, even leading to disability.
A perineural vertebral cyst does not threaten the patient's life. If detected early, it can be treated with medication. Education will not reduce the quality of life if it is detected and controlled in time. But the patient must be registered with a neurologist, follow medical recommendations and undergo routine examinations.
Why is it worth having surgery to remove a spinal cyst at the Pirogov Clinic?
- Neurosurgeons of the highest category, with more than 10 years of experience, with a scientific degree in medicine. Sci.
- Modern equipment in operating rooms.
- Affordable prices for spinal cyst removal.
- Positive reviews about spinal surgeries and treatment in our clinic. You can view them on our website, as well as on independent platforms, for example Napopravka.ru.
- Hotel-type rooms.
- You can get a recommendation from a neurosurgeon for the treatment of your disease completely free of charge. You can submit MRI images on this page of the website.
- Possibility of obtaining an installment plan or a loan for treatment.
- Service under VHI policies.
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Possible complications
One of the complications of this disease is relapse. Also, if the operation was unsuccessful, the cyst may open. This is dangerous due to the leakage of cerebrospinal fluid into the cavity, which entails meningitis or the formation of a large cerebrospinal fluid cushion of soft tissues.
To stop liquorrhea, a very complex operation is necessary. Doctors are still arguing whether it is advisable to operate on a Tarlov cyst. Therefore, if the symptoms do not pose a threat to life, they try not to touch the tumor.
Literature and sources
- Movshovich I.A., Illarionov V.P., Mattis E.R., Mitbrait I.M., Nikityuk B.A., Tager I.L., Freidin L.M., Tsivyan Ya.L. Spine // Great Medical Encyclopedia: 30 volumes / chapter. ed. B.V. Petrovsky. — 3rd ed. - Moscow: Soviet Encyclopedia, 1983
- Krylova N.V., Iskrenko I.A. Anatomy of the skeleton. Human anatomy in diagrams and drawings. Atlas manual. - M.: Publishing house of the Russian Peoples' Friendship University, 2005.
- Human anatomy. In two volumes / Ed. M. R. Sapina. — 5th ed., revised. and additional - M.: Medicine, 2001.
Video on the topic:
Clinical case in the larynx department of the Federal State Budgetary Institution National Medical Research Center of the Federal Medical and Biological Agency of Russia
Patient M. , 26 years old, on June 20, 2016, sought medical help from specialists from the Department of Laryngeal Diseases of the Federal State Budgetary Institution National Medical Research Center for Medical and Biology of the Federal Medical and Biological Agency of Russia with a complaint about the presence of a mass on the right side of the neck. According to the patient, the formation appeared in September 2015, and gradual growth was noted. After an MRI examination and ultrasound of the neck, a diagnosis of “lateral neck cyst” . On the right side of the neck, the contours of the cyst are visualized from the mastoid process of the temporal bone to the clavicle; upon palpation it is dense, the surface is smooth.
View of the patient's neck before surgery | MRI images of patient M. | |
On June 21, 2016, the patient underwent removal of a benign neck tumor.
Surgery to remove a lateral cyst in patient M. | ||
Size of removed tumor: 20 cm by 6 cm
In the postoperative period, patient M. received antibacterial therapy, the suture was removed on the 7th day.
She was discharged on June 29, 2016 with improvement.
Photo of the patient immediately after surgery | Photo of the patient upon discharge |