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Explain the meaning of Sizeable synovial cyst arising from the right facet joint, disc herniation

I have been in alot of pain from my back down into my right leg. I cant walk long , cant sit long to bend or twist is a killer and the more time goes by the worse it gets. They have put me on toradol but that barely touches it...suggestions? This is my MRI results TECHNIQUE: A combination of T1, T2, fat nulled fast inversion recovery images and/or gradient echo sequences was used as appropriate to clinical context. Following the uneventful intravenous administration of Gadolinium based contrast (Magnevist), T1 weighted images in various planes were obtained. FINDINGS: The L1-L2 and L2-L3 discs are desiccated. No quantifiable epidural disc disease occurs; bony spinal canal and neural foramina are normally patent at these levels. At the L3-L4 level, there is a sizeable synovial cyst arising from the medial aspect of the right-sided facet joint. It projects medially into the bony spinal canal by about 7 mm. There is near total effacement of CSF from about the cauda equina at this level and I would characterize the appearance as one of at least a mild to moderate frank spinal stenosis , with preferential effect upon right-sided neural elements. The superoinferior extent of the meniscal cyst is roughly 12 mm. The neural foramina remain patent at this level, despite the possible presence of a distal foraminal/lateral disc herniation at the right side, which may nonetheless affect the more peripheral exiting L3 nerve root on the right. Correlation is suggested. At L4-L5, there is minimal disc bulge into the anterior epidural space which flattens the ventral theca to abut the intrathecal course of the traversing L5 nerve roots, without displacing them. Frank spinal stenosis is not seen. There is a shallow foraminal disc herniation seen at the right side at L4-L5 extending posterior to the vertebral margin by about 2 to 3 mm or so. This compromises the caudal aspect of the neural foramen to a minimal degree. Perineural fat is preserved about the exiting L4 nerve root on the right. Left-sided neural foramen is widely patent. At L5-S1, the disc is desiccated. The level is otherwise unremarkable. Bone marrow signal is normal. The conus is of normal morphology, signal and position. Contrast was administered, and demonstrated mild enhancement of dura covering the synovial cyst arising from the medial aspect of the right L3-L4 facet. CONCLUSION: Abnormal study. Sizeable synovial cyst arising from the right L3-L4 facet joint and compromising the bony spinal canal particularly right-sided neural elements as above. There is likely a distal foraminal/lateral disc herniation occurring at the right side of L3-L4 which may affect the exiting L3 nerve root, additionally. There is a shallow right-sided foraminal disc herniation at L4-L5 which does not seem to have effect upon neural elements.
Asked On : Sun, 7 Oct 2012
Answers:  1 Views:  277
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Orthopaedic Surgeon, Joint Replacement 's  Response
Feb 2014

Thanks for posting your query.

You are suffering from PIVD. Disc prolapse at L3-L4 at right side causes prssure over nerve root ,that is the cause of pain in area of L3 nerve root distribution.

So you have to discuss with your surgeon regarding surgery (discectomy).

Meanwhile you have to do physiotherapy,anti inflammatory drugs.

Hope I have answered your query.

Answered: Sun, 7 Oct 2012
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