Symptomatic cervical synovial cyst associated with an os odontoideum diagnosed by magnetic resonance imaging: case report and review of the literature

Unilateral facet cyst at the atlantoaxial joint leading to cervical myelopathy: A case report and review of literature

Background

Spinal synovial cysts are rare in the cervical spine where they may cause myeloradiculopathy. Contrast MR studies help differentiate these from other lesions. The optimal treatment is often surgical removal.

Case Description

A 47-year-old male presented with axial neck pain, numbness, and left-hand paresthesia. When the MR study showed dorsolateral cord compression due to a left-sided C1-C2 facet cyst, he underwent a unilateral decompression/fusion. Adequate cyst removal/excision was documented on a postoperative MR performed 2 weeks and 3 months postoperatively.

Conclusion

A 47-year-old male presented with myelopathy attributed to an MR-documented dorsolateral C1/ C2 facet cyst. Following excision/decompression of the cyst and posterior fusion, the patient's symptoms/signs resolved.

Cervical myelopathy caused by ventrally located atlanto-axial synovial cysts: An open quest for the safest and most effective surgical management. Case series and systematic review of the literature

OF BACKGROUND DATA

Despite a good understanding of the natural history of spinal synovial cysts (SCs), a widespread agreement regarding their optimal management is still lacking. This is particularly true for SCs occurring at the C1-C2 level, which are rare, but oftentimes lead to a rapidly evolving cervical myelopathy.

METHODS

We report a series of 4 patients (M:F ratio=1:1; mean age 63.5 years) presenting with progressive cervical myelopathy secondary to ventrally located C1-C2 SCs. All patients underwent a postero-lateral facet-sparing intradural approach with total excision of the SCs. Functional status was assessed pre- and postoperatively with Nurick scale and the modified Japanese Orthopaedic association grading. Furthermore we conducted a systematic review, following PRISMA guidelines of pertinent literature to contextualize the options for surgical management of such lesions.

RESULTS

Complete excision of the SCs was confirmed radiologically and on histological analysis. All measures of functional status improved post-operatively, and no cyst recurrence or need for instrumented fusion were noted during follow up (range from 22 to 88 months).

CONCLUSION

Our experience suggests that the facet-sparing intradural approach provides excellent clinical outcomes without causing any C1-C2 instability. This is in keeping with the take home message emerging from our literature review, which confirms that treatment should aim at radical resection of SCs while minimizing the risk of postoperative instability.

Magnetic Resonance Imaging Features of Cervical Spine Intraspinal Extradural Synovial Cysts

Spinal synovial cysts are relatively uncommon and are most frequently found in the lumbar spine and rarely in the cervical spine. Intraspinal extradural cervical synovial cysts can occur and potentially cause cord/nerve root compression with symptoms of myelopathy/radiculopathy; however, most are asymptomatic and incidental findings. We conducted a literature review and present, to our knowledge, the largest imaging case series and describe the magnetic resonance imaging features of cervical synovial cysts.

Immediate Reduction of a Retro-odontoid Synovial Cyst Following Lateral Atlantoaxial Joint Puncture and Arthrography: A Case Report

STUDY DESIGN

Case report.

OBJECTIVE

We report on a case with a retro-odontoid synovial cyst, and the immediate reduction of the cyst was confirmed after lateral atlantoaxial joint puncture and arthrography.

SUMMARY OF BACKGROUND DATA

Retro-odontoid synovial cysts are rare diseases located posteriorly to a dense axis. Because most reports have focused on surgical treatment, only a few have examined nonsurgical treatment. However, several months are required after nonsurgical treatment until cyst regression.

METHODS

A 52-year-old female presented with atlantoaxial instability. She complained of neck pain and numbness in her hands. Magnetic resonance imaging revealed a retro-odontoid synovial cyst. Lateral atlantoaxial joint puncture and arthrography were performed.

RESULTS

Two days after treatment, the patient showed significant improvement in the numbness of her hands, and a follow-up magnetic resonance imaging revealed an immediate reduction in the cyst. During a 4.5-year follow-up period, no recurrence of the clinical symptoms occurred.

CONCLUSION

Lateral atlantoaxial joint puncture may immediately reduce retro-odontoid synovial cysts, and the lateral atlantoaxial joint has a communication channel with the retro-odontoid synovial cyst via the atlantodental joint. Once disappearance of the cyst is confirmed, an acceptable long-term outcome can be achieved with nonsurgical treatment even in cases with atlantoaxial instability.

LEVEL OF EVIDENCE

N/A.

Acute Traumatic Cervical Cord Injury in Pediatric Patients with os Odontoideum: A Series of 6 Patients

OBJECTIVE

Os odontoideum can lead to instability of the atlantoaxial joint and places the spinal cord at significant risk for acute traumatic catastrophic events or chronic neurologic change. The purpose of this study was to retrospectively review acute cervical cord injury after minor trauma in 6 pediatric patients with os odontoideum.

METHODS

Between 2012 and 2013, 6 pediatric patients with os odontoideum who suffered acute traumatic cervical cord injury were reviewed retrospectively. Their clinical history, neurologic symptoms, radiological investigations, follow-up period, American Spinal Injury Association (ASIA) impairment classification, and motor score were reviewed.

RESULTS

There were 2 male and 4 female subjects ranging in age from 4 to 18 years (mean 11.8 years). Before the traumatic injury, 2 cases were asymptomatic and 4 complained of myelopathic feature with unsteadiness on feet. Falls were the most common injury (n = 5), followed by a minor motor vehicle accident (n = 1). Atlantoaxial instability and cord compression were presented in all cases with dynamic cervical lateral radiographs and magnetic resonance imaging. Most patients presented with spinal cord thinning and hyperintensity on T2-weighted sequences in magnetic resonance imaging. Spinal cord compression was anterior in 2 cases and both anterior and posterior in 4. Two patients was classified as ASIA B, 1 as ASIA C, and 3 as ASIA D category on admission. Two patients presented with respiratory failure with mechanical ventilation for over 2 weeks in perioperative period. Postoperatively, all patients improved neurologically and clinically after underwent posterior atlantoaxial fixation and fusion.

CONCLUSIONS

Pediatric patients with asymptomatic or myelopathic atlantoaxial instability secondary to os odontoideum are at risk for acute spinal cord injury even after minor traumatic injury. Sufficient fixation and fusion should be undertaken as prophylactic treatment of developing myelopathy and to improve neurologic symptoms with acute traumatic cervical cord injury in pediatric patients with os odontoideum.

Ganglion cyst of the cruciate ligament with atlantoaxial subluxation

BACKGROUND

Ganglion cysts of the cruciate ligament are rare and sometimes asymptomatic. The authors present three cases of ganglion cysts of the cruciate ligament with atlantoaxial subluxation, which has rarely been reported previously.

METHODS

Generally, ganglion cysts of the cruciate ligament are reported as case reports. Several theories regarding the process of cyst formation and the development of treatment options have been described. However, trans-oral decompression with total removal of the cyst may be one of the options for treatment of this kind of disease.

RESULTS

A retrospective review of three patients, two female and one male patient, with a mean age of 68 years was conducted. The operation performed was a trans-oral decompression with cyst removal for all patients. Clinical outcomes were evaluated after the operation. All patients underwent trans-oral decompression with total removal of the cyst, followed by posterior fusion and pathologic examination of the cyst, revealing myxoid stroma with an absence of synovial linings.

CONCLUSION

The ganglion cysts and synovial cysts of the cruciate ligament are two different diseases with different presentation, pathogenesis, pathophysiology, and pathologic findings.

Cervical degenerative intraspinal cyst: a case report and literature review involving 132 cases

Intraspinal and extradural cysts in the cervical spine are rare disorders that may cause myelopathy or radiculopathy. A synovial cyst or ganglion derived from the facet joint and that from a ligamentum flavum have been reported. We report a surgical case of degenerative intraspinal cyst, causing cervical myelopathy. MRI of a case revealed cystic lesion at C4-5. Spinal cord was compressed by cyst and symptoms of myelopathy were also observed. The patient with cervical spinal canal stenosis underwent laminoplasty and excision of the cyst. The patient recovered well immediately after the surgery. Literature review showed that 133 patients have been reported, including the present case. Previous reports indicated that most cysts occurred in old patients and at the atlanto-axial or C7-T1 junction, and laminectomy or laminoplasty with excision of the cyst gave good results in most cases.

Cervical juxtafacet cyst after anterior cervical discectomy and fusion

Anterior cervical discectomy and fusion (ACDF) is a common neurosurgical procedure, and the benefits, long-term outcomes, and complications are well described in the literature. The development of a juxtafacet joint cyst resulting in radiculopathy is a rare outcome after ACDF and merits further description. The authors describe a patient in whom a juxtafacet joint cyst developed after ACDF procedures, resulting in surgical intervention. When a juxtafacet joint cyst develops after ACDF, symptoms can include radiculopathy, neck pain, and neurological symptoms such as paresthesias and motor weakness. The presence of a juxtafacet joint cyst implies instability in that region of the spine. Patients with this pathological entity may require decompression of neural elements and fusion across the segment involved with the cyst.

Cervical juxtafacet cyst with myelopathy due to postoperative instability. Case report

A 74-year-old man presented with a cervical juxtafacet cyst on the right side of C5-6 and prominent myelopathy. He had been treated with anterior cervical discectomy and fusion at C4-5 as well as anterior foraminotomy of the right C5-6 lesion 20 months previously. The patient underwent complete surgical excision of the lesion. The patient recovered uneventfully, and the myelopathy resolved. Reexamination of the images revealed that we failed to investigate a suspicious minimal cervical juxtafacet cyst on the initial preoperative images and that the degree of subluxation at C5-6 on flexion radiography had increased postoperatively. Therefore, the surgeon should be aware that juxtafacet cyst can be progressive in planning of cervical spinal surgery which can cause or aggravate instability in the presence of an incidental, suspicious juxtafacet cyst on preoperative imaging at the same level, even if the lesion is very small and subclinical.

Cystic deterioration of the C1-2 articulation: clinical implications and treatment outcomes

OBJECT

Synovial cysts of the cervical spine are rare. Further, synovial cysts of the C1-2 articulation, or retroodontoid cysts, are very rare, with fewer than 20 cases reported overall. The authors report on a single-institution series of 10 patients with C1-2 retroodontoid synovial cysts.

METHODS

The charts of 10 patients with pathologically confirmed synovial cysts following resection between January 1998 and June 2009 were reviewed. The clinical presentation, radiographic findings, surgical management, and pre- and postoperative functional levels (reported as a modified Rankin outcome) are reported.

RESULTS

All 10 patients underwent attempts at complete resection of the synovial cyst; none of the lesions were simply aspirated. All 4 patients with an initial recommendation of observation alone ultimately underwent surgery because of their swift neurological deterioration. The mean age at surgery was 75.4 ± 4.6 years (range 54-81 years). The mean presenting cyst volume was 4.6 ± 1.7 cm(3). Nine of 10 patients underwent transoral resection of the cyst with posterior fusion. Six of the 10 patients underwent additional posterior laminectomy for decompression. The hospital length of stay varied from 2 to 45 days, with a mean of 19 ± 7 days. All patients undergoing transoral decompression had varying degrees of difficulty with postoperative dysphagia, diagnosed using videofluoroscopy. All patients improved in their modified Rankin Scale score after surgical intervention with a mean follow-up of 42 months (95% CI 12-72 months).

CONCLUSIONS

Synovial cysts of the atlantoaxial joint are rare. They occur in older patients in whom clinical deterioration is likely to occur. In most cases, these cysts can be diagnosed preoperatively. Transoral decompression with posterior fusion is an effective treatment for C1-2 degenerative cysts and can be accomplished with few complications. However, the ideal treatment for these lesions remains unknown.

Cervical synovial cyst: case report and review of literature

Synovial cysts, typically observed in the lumbar spine eventually associated with degenerative changes of the facet joints, only rarely present in the cervical spine. Up to now, only 28 symptomatic cases are described in literature. Typically, the treatment of these cases is a decompressive laminectomy followed by complete surgical removal of the lesion. The authors present the case of an 84-year-old man with a symptomatic synovial cyst involving the space between C7 and T1.

Os odontoideum: etiology and surgical management

OBJECTIVE

Os odontoideum is an independent ossicle of variable size with smooth circumferential cortical margins separated from the foreshortened odontoid peg. The etiology of os odontoideum remains controversial, but there is now emerging consensus on the traumatic etiology of os odontoideum rather than a congenital source.

RESULTS

We reviewed the literature of os odontoideum. Patients with this condition can be asymptomatic or present with wide range of neurological dysfunctions. Although the diagnosis of os odontoideum can be made with plain x-rays, further imaging modalities including magnetic resonance imaging and computed tomography angiography have improved the preoperative planning.

CONCLUSION

There is a role for conservative treatment of an asymptomatic incidentally found, radiologically stable, and noncompressive os odontoideum. Conversely, surgery has a definite role in symptomatic cases. The main method of surgical treatment today is posterior decompression after reduction and fusion via independent C1 and C2 instrumentation. Irreducible, persistent anterior compression from os odontoideum can be approached by a transoral route with good results in experienced hands.

Bipartite atlas with os odontoideum and synovial cyst: case report and review literature

STUDY DESIGN

Case report and review of the literature.

OBJECTIVE

To present an os odontoideum with bipartite atlas and synovial cyst at the C1-C2 junction in a 13-year-old girl and to review the relevant background literature.

SUMMARY OF BACKGROUND DATA

Bipartite atlas associated with os odontoideum and synovial cyst at the C1-C2 junction is extremely rare.

METHODS

The patient's clinical presentation, evolution of physical findings, and sequential radiologic studies. Surgery of the bipartite atlas with os odontoideum and synovial cyst. Posterior fixation between occipital and C 2 without resection of the mass was performed.

RESULTS

The patient had significant improvement and spontaneous regression of the cyst was identified on the follow-up magnetic resonance imaging (MRI) taken 3 months after posterior fixation. To our knowledge, no case of a bipartite atlas with os odontoideum and synovial cyst with complete recovery of an accompanying quadriparesis after reduction has been previously reported in English medical literature.

CONCLUSION

We described a rare association of an anterior arch defect, posterior arch aplasia, os odontoideum, and synovial cyst at the C1-C2 junction. This case report supports surgical intervention of synovial cyst with craniovertebral instability using posterior fixation without resection of the cyst.

Surgical approach for synovial cyst of the atlantoaxial joint: a case report and review of the literature

STUDY DESIGN

Case report and review of the literature.

OBJECTIVE

We describe the first case of a synovial cyst arising from pseudarthrosis of a previous dens fracture. The literature is reviewed and etiological, diagnostic, and therapeutic options of atlantoaxial cysts are discussed.

SUMMARY OF BACKGROUND DATA

Symptomatic synovial cysts of the atlantoaxial joint are rare. To the authors' knowledge only 24 cases have been reported.A 60-year-old patient presented with bilateral hand numbness, quadrihyperreflexia, and gait deterioration. Magnetic resonance imaging of the cervical spine disclosed a cystic mass located at the transverse ligament of dens axis causing bulbomedullary compression.

METHODS

Surgery was performed via transoral image guided approach. The ventral atlas arch, dens, transverse ligament, tectorial membrane, and the compressing cyst were removed, followed by a C0-C3 fusion.

RESULTS

Two months postsurgery the patient recovered completely from the cervical myelopathy with transient remnant dysparesthesia of the finger tips.

CONCLUSION

Magnetic resonance imaging findings are not specific enough to establish a preoperative diagnosis. Radical resection via image-guided transoral route followed by posterior fusion allows complete resection of the cystic lesion and results in excellent long-term decompression.

Ganglion cyst of the cervical spine presenting with Brown-Sequard syndrome

Ganglion cysts of the spine are uncommon. They occur mostly in the dorsolateral trunk and arise with the greatest frequency in the lumbar spine. However, they are rarely symptomatic. We report a rare case of a patient with a ganglion cyst of the lower cervical spine presenting with acute Brown-Sequard syndrome. The patient had no history of trauma. Magnetic resonance imaging of the cervical spine showed a cystic lesion connecting to the synovial joint C6-7 and compressing the posterior aspect of the spinal cord. The patient underwent emergent C6-7 laminectomy with total removal of the cyst. Neurological function recovered completely 4 months after operation. Ganglion cysts should be considered in the differential diagnosis of an extradural mass of the cervical spine. Magnetic resonance imaging provides a rapid and correct diagnosis, and laminectomy with removal of the cyst results in good neurological recovery.

Cervical degenerative cyst located within the body of C2: a case report and review of the literature

STUDY DESIGN

A case report and review of the literature are presented.

OBJECTIVES

To describe the clinical course and treatment of a patient with an unusual intraosseous degenerative cyst within the body of the axis, as well as review the literature regarding these lesions.

SUMMARY OF BACKGROUND DATA

Intraosseous degenerative cysts of the cervical spine are extremely rare. To our knowledge, only 4 prior case studies have described these lesions, 2 of which were seen in the body of C2.

METHODS

A case report of a 58-year-old patient with neck pain and an intraosseous cyst within the axis is presented with a review of the pertinent literature.

RESULTS

History, examination, radiographic evaluation, and histology revealed this lesion to be an intraosseous degenerative cyst within the body of C2. The patient was treated with anterior surgical biopsy/curettage and posterior stabilization with structural graft enhancement.

CONCLUSION

Although rare, intraosseous cervical degenerative cysts should be present in any differential diagnosis of cystic lesions seen in the cervical spine.

Lumbar hemorrhagic synovial cysts: diagnosis, pathogenesis, and treatment. Report of 3 cases

BACKGROUND

To define the etiologic, clinical, histological, and surgical features of lumbar hemorrhagic synovial cysts (LHSCs). Three personal cases are reported together with a review of the pertinent literature.

METHODS

We identified 3 cases of LHSC treated in our departments and 20 cases culled from the literature.

RESULTS

A total of 23 cases of LHSC were selected. All the patients underwent surgical treatment because of untreatable radicular pain and/or neurological deficits. The amount of bleeding, either massive or minor but repeated, influenced the timing of surgery. In our cases, the histological examinations showed an inflammatory reaction within the cyst and the consequent formation of neoangiogenic vessels.

CONCLUSIONS

Hemorrhagic synovial cyst of the spine is rare and its most common localization is lumbar. Bleeding within the cyst leads to an increase of its volume, accompanied by neurological deficits and/or painful symptoms that are violent and generally intractable. In this event, surgical excision is the treatment of choice and, in some cases, emergency surgery is necessary. Hemorrhages are probably caused by the rupture of fragile neoangiogenic vessels.

Synovial Cyst at the C1-C2 Junction in a Patient with Atlantoaxial Subluxation

Synovial cysts of the cervical spine causing myelopathy are rare. The pathogenesis of these cysts is often attributed to degenerative changes of the facet joints or microtrauma. The authors report a synovial cyst at the C1-C2 junction in a patient with atlantoaxial subluxation without a congenital anomaly or inflammatory conditions. A 72-year-old man presented with a progressive right-sided myelopathy attributed to a C1-C2 synovial cyst accompanied by atlantoaxial subluxation and C3-C6 spondylosis. Magnetic resonance imaging of the cervical spine showed a large cystic mass compressing the spinal cord located at the C1-C2 junction. A C1 hemilaminectomy, complete evacuation of the cyst contents, and posterior atlantoaxial fusion were performed, and a double-door laminoplasty was also done at C3-C6. The patient showed significant improvement of paresthesia and motor weakness of the right upper and lower extremities immediately after the operation. Synovial cysts should be considered in the differential diagnosis of an extradural mass of the upper cervical spine. Posterior fusion combined with direct excision of the cyst may be the optimum treatment of a synovial cyst at the C1-C2 junction in a patient with atlantoaxial subluxation.

An Expanding Cervical Synovial Cyst Causing Acute Cervical Radiculopathy

Synovial cysts of the cervical spine occur infrequently in the spinal canal and are most often associated with degenerative facet joints. Despite the prevalence of degenerative spinal disease, symptomatic synovial cysts are extremely uncommon. We report a rare case that showed an exacerbation of a cervical radiculopathy due to an acute expansion of the synovial cyst. Magnetic resonance (MR) images originally revealed a small cystic extradural lesion when the patient presented with neck pain and slightly numbness in the right hand. The patient's complaints subsequently subsided after administration of pain killers. However, 2 weeks after this, the patient experienced a spontaneous, sudden, severe radiating pain into the right arm without any accompanying cervical injury. MR images showed that the cyst had become markedly increased in size in the intervening 4 weeks and compressed the spinal cord laterally. Because the arm pain was so severe and neurologic examinations revealed the paralysis of the C8 nerve root, the synovial cyst was excised surgically and a good clinical outcome achieved. Thus, even if symptoms are mild and the size of the synovial cyst is small, acute expansion of the cyst might be rarely observed and careful management, including surgical consideration, is needed.

Intraspinal synovial cyst communicating with the C1-C2 facet joints and subarachnoid space associated with rheumatoid atlantoaxial instability

STUDY DESIGN

The first case of intraspinal synovial cyst communicating with the C1-C2 facet joints and subarachnoid space associated with rheumatoid atlantoaxial instability is presented.

OBJECTIVES

To describe the diagnosis and successful treatment of a synovial cyst of the C1-C2 junction in a patient with rheumatoid arthritis and atlantoaxial instability.

SUMMARY OF BACKGROUND DATA

Intraspinal synovial cysts of the C1-C2 junction are extremely rare. Neither association with rheumatoid atlantoaxial instability nor communication with the C1-C2 facet joints and the subarachnoid space has been previously reported in a synovial cyst of the C1-C2 junction.

MATERIALS AND METHODS

The clinical and radiologic features of a 71-year-old woman with a symptomatic synovial cyst of the C1-C2 junction with rheumatoid atlantoaxial instability are detailed. Posterior atlantoaxial fusion alone was performed.

RESULTS

Preoperative magnetic resonance images demonstrated a large cystic mass around the dens, compressing the spinal cord. The mass was of low signal intensity on T1-weighted images, was of high signal intensity on T2-weighted images, and was enhanced marginally with gadolinium-DTPA on T1-weighted images. Computed tomograms performed after myelography disclosed the cyst around the dens communicating with the subarachnoid space and the C1-C2 facet joints. Spontaneous regression of the cyst was identified on the magnetic resonance images 3 months after surgery. One year after surgery, myelopathic symptoms were improved.

CONCLUSION

An intraspinal cyst communicating with the C1-C2 facet joints and subarachnoid space associated with rheumatoid atlantoaxial instability was reported. Computed tomograms after myelography were useful in delineating the relationships among the synovial cyst, facet joints, and the subarachnoid space. Spontaneous regression of the cyst and clinical improvement were achieved by C1-C2 posterior fusion alone.

Symptomatic intraosseous synovial cyst in the cervical spine: a case report

STUDY DESIGN

A case report and review of the literature are presented.

OBJECTIVE

To describe an unusual location for a cervical synovial cyst and to review characteristic presentations and findings of synovial cysts in the cervical spine.

SUMMARY OF BACKGROUND DATA

Synovial cysts in the cervical spine are rare. To date, only 27 have been reported in the literature. None, however, has been reported as cysts involving or eroding into the vertebral body.

METHODS

A single case of an intraosseous synovial cyst in the cervical spine is presented with a review of the literature.

RESULTS

History, examination, and radiographic evaluation suggested an intraosseous cystic lesion, which pathologically was determined to be synovial in origin.

CONCLUSIONS

We present a case of a cervical synovial cyst in a previously undescribed intraosseous location in the cervical spine, treated successfully with surgical excision.

Ganglion cyst of the spinal anterior longitudinal ligament presenting as a retropharyngeal mass

Cervical spinal synovial and/or ganglion cysts can occur at various periarticular sites and should be considered in the differential diagnosis of intraspinal-extradural or paraspinal masses of the cervical spine. The first report of a ganglion cyst of the cervical anterior longitudinal ligament presenting as a retropharyngeal mass, is presented. The histopathology, etiology, and clinical aspects of synovial and ganglion cysts of the cervical spine are briefly reviewed.

Degenerative intraspinal cyst of the cervical spine: case report and literature review

STUDY DESIGN

A case report and a literature review are presented.

OBJECTIVE

To describe and review the clinical presentations, characteristic findings from imaging studies, and treatment of synovial and ganglion cysts arising within the cervical spinal canal.

SUMMARY OF BACKGROUND DATA

Synovial and ganglion cysts in the cervical spine are rare. To the authors' knowledge, 24 sporadic cases in all, designated by various terms, have been reported in the literature.

METHODS

Three cases of synovial and ganglion cysts in the cervical spine are reported as well as a review of the literature.

RESULTS

Characteristic findings from imaging studies included a fluid-containing extradural lesion demonstrated on magnetic resonance images and gas content in the lesion demonstrated on ordinary or sagittally reconstructed computed tomography images. A laminectomy with removal of the cyst was the treatment of choice in most cases.

CONCLUSIONS

Neither communication with an adjacent facet joint nor histopathology of the cyst wall provides a persuasive basis for differentiating ganglion, synovial cyst, and cyst arising from the ligaments. To accommodate the varied presentations, the authors propose a comprehensive term for these lesions: "degenerative intraspinal cyst."