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Should I be concerned about the spinal cyst? Lower back pain radiating to legs

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Pediatrician, Infectious Diseases
Practicing since : 2005
Answered : 1528 Questions
should I be concerned with a 8mm cyst on the right side of the L4-L5, and am having lower back pain and it radiates down into my legs?
Posted Fri, 15 Jun 2012 in Back Pain
Answered by Dr. Hema Yadav 9 hours later
Thanks for posting your query.
Intraspinal synovial cysts are more common in women, with 90% of lesions occurring in the lumbar region, predominantly at the L4 – L5 level. It occurs mostly due to instability of joints or arthritis or sponsyloarthropathy.Clinical manifestations include motor and sensory deficits and reflex changes.
There are three main treatment choices for synovial cysts in the lumbar spine:
1.Observation and activity modification .
If the synovial cyst is not creating a lot of dysfunction or pain in the patient’s daily life, no medical treatments may be necessary. Since the pain is usually caused by certain positions, changing positions is a reasonable way to deal with the pain as long as a you can still function adequately.
2. Steroid injections ,There are two types of injections that can be helpful to alleviate the pain: facet injections or epidural injections.
3. Surgery .The most common kinds of spine surgery for synovial cysts can be either a decompression alone or a decompression with a spine fusion.

Considering your case , it's advisable that you consult a neurosurgeon for the further management as spinal cyst with radiating pain could be most probably due to instability of the joints ( facet joints ) and are causing significant compression to the spinal nerves.
The most reliable treatment is surgical decompression and if necessary , fusion of the unstable joints.
However the decision for surgery can be taken by your doctor after complete evaluation considering ,
The amount of pain you are having
The length of time of your symptoms
The amount of dysfunction it causes in your life.
Sometimes it's best to try out the conservative methods like physiotherapy and steroid injections for pain relief before going for drastic surgery.
So I would advise you to consult a neurosurgeon and physiotherapist for grading the severity of your problem and carrying out further management .
Hope this answers your query .
Wishing you good health.

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