Transoral surgical approach for treatment of symptomatic atlantoaxial cervical synovial cysts.

Abstract

AIM:

Synovial cysts are relatively common in the lumbar spine and very uncommon in the cervical spine. Several case reports and a few small series have been reported in the literature over the past four decades. There are two distinct cervical spine synovial cyst categories: atlantoaxial and the subaxial cervical spine. The surgical treatments are very different.

MATERIAL AND METHODS:

We report eleven patients undergoing transoral resection and posterior fusion for histologically confirmed symptomatic atlantoaxial synovial cysts. This represents a retrospective review over 18 years. The authors analyzed the literature of patients who underwent surgical treatment for symptomatic atlantoaxial synovial cysts.

RESULTS:

There were four male and seven female patients with a mean age of 76 years (range 54-84 years). All patients presented with cervical myelopathy. Patients were neurologically assessed pre- and postoperatively and outcome reported using the Modified Rankin Outcome score. Mean follow-up period was 22 months (range 6-120 months). Ten of the eleven patients had improvement in their postoperative assessment and one patient remained unchanged.

CONCLUSION:

Myelopathy is the presenting symptom in the vast majority of these patients. Surgical resection and decompression of the neural structures can be an effective treatment for symptomatic atlantoaxial synovial cysts.

• Authors: Mark K Lyons, Barry Birch
• Journal: Turkish neurosurgery (Turk Neurosurg) Vol. 21 Issue 4 Pg. 483-8 ( 2011) ISSN: 1019-5149 [Print] Turkey
• PMID: 22194104 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Atlanto-Axial Joint (pathology, surgery)
• Decompression, Surgical (methods)
• Female
• Follow-Up Studies
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Mouth (surgery)
• Retrospective Studies
• Spinal Cord Compression (pathology, surgery)
• Spinal Fusion (methods)
• Synovial Cyst (pathology, surgery)
• Treatment Outcome