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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is synovial cyst curable?

Answered by
Dr.
Dr. Jasvinder Singh

Internal Medicine Specialist

Practicing since :1998

Answered : 1578 Questions

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Posted on Fri, 4 May 2012 in Brain and Spine
Question: age: 57,
weight: 71kg,
height: 5"6
medical history: diabetic, has swollen prostrate glands but not very serious and the doctors control both the problems with medicine
Recently had a pain in the right leg when walking and couldn't walk for long and had to sit down
Did an MRI scan, here are the results
- diffuse disc bulge at the level of L3-L4 & L4-L5 compressing the thecal sac and traversing nerve root on both sides. Ligamentum unfolding is seen at this level adds to canal compromise.
- broad based posterier disc herniation at the level of the L5-S1 indenting the thecal sac and traverse roots on both sides
- facetal joint arthropathy at the level of L3-4, L4-5 & L5-S1. A small T2 hyperintense cystic lesion measuring 8.2 * 3.8mm is seen in the region of ligamentum flavum at the level of L5-S1 communicating with the right facet joint- suggestive of synovial cyst. it indents the thecal sac and right traversing nerve root.
i want to find out how serious the problem is..the doctor has prescribed a pain killer but so far no change in the pain in the leg..still can't walk for long..
is it curable?
and is there anything we can do about the pain?
thank you
doctor
Answered by Dr. Jasvinder Singh 42 minutes later
Hello,

Thanks for posting yoru query.

The MRI reports and the symptoms are suggestive of spinal disc herniation , facetal joint arthropathy and syncovial cyst in the spine. Regarding the spinal disc herniation which is also called slipped disc, it is a condition affecting the spine, in which a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion to buldge out.

The majority of herniated discs will heal themselves in about six weeks and do not require surgery. Non-surgical methods of treatment are usually attempted first, leaving surgery as a last resort and in this non steroidal drugs, lumbosacral back support and steroid injections are very useful.

Surgery should only be considered as a last resort after all conservative treatments (non-surgical therapy) have been tried. And these include facetectomy, foraminotomy, intervertebral disc annuloplasty, intervertebral disc arthroplasy, laminoplasty, laminotomy, microdiscectomy or spinal laminectomy. Hence that is the reason your orthopedician is giving conservative methods a trial first.

Regarding the facetal joint arthropathy which is a degenerative disease that affects the joints of the spine and is found in people > 65 years of age; first of all conservative methods using pain killers and steroids is tried and if they fail then steroid injections in the joint or sinu-vertebral nerve ablation which destroys nerves with electrical current may be an option. But this should be kept as last option.

In synovial cyst also, first wait and watch policy is adopted. But since you are having pain after walking a short distance, it will be better to either drain the cyst (best done by a neurosurgeon) or inject steroid injections to decrease inflammation. You can discuss these two treatment options with an orthopedician/ neurologist.

Surgical treatment is not without side effects and includes decompression alone or a decompression with a spine fusion. But this option should be entertained last of all. Currently you can be managed with steroid injections or synovial cyst drainage.

Pain can be managed with pain killers which you have been prescribed or steroid injections in the joint and cyst.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Regards

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Jasvinder Singh 22 hours later
i already take
Lycox,
Aztor 5mg for my cholestrol problem,(sorry, forgot to mention that before)
Glynase for diabetes
Geriflo_d for prostrate
and the recent doctor prescribed metnere for backbone.

the other medicine he prescribed are Torcoxia bcd 120, relmus 8mg, qgold which i have not started taking yet. 1) Is it ok to take these medicine with the other medicines mentioned above and if not, which one should be left out? 2) Are these the correct medicine for a problem like this?
thank you
doctor
Answered by Dr. Jasvinder Singh 17 hours later
Hello XXXXXXX

Thanks for writing back.

The tablets that you have been prescribed basically contain etoricoxib and thiocolchicoside which are used for analgesic (pain killer), anti inflammatory and muscle relaxant properties. These drugs won't interfere with the drugs that you are already taking and you have to take them as prescribed.

They are the correct medicines, you can go ahead taking them.

Hope this answers your query. If you have additional questions or follow up queries then please do not hesitate in writing to us. I will be happy to answer your queries.

Wishing you good health.

Regards,
Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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