Full Endoscopic Resection of Giant Synovial Cyst in the Lumbar Spine: A Case Report.

Abstract

Introduction: Synovial cysts of the lumbar spine are rare pathologies that can cause significant nerve root compression. Traditional surgical treatments often involve open laminectomy with medial facetectomy, which often lead to instability requiring fusion and instrumentation. We present a case of a giant synovial cyst at the L4-L5 level successfully treated using full endoscopic inter-laminar approach.

Case report: A 69-year-old male presented with chronic low back pain and left leg radiculopathy. Imaging revealed a giant synovial cyst at L4-L5 level causing severe significant nerve root compression. The patient underwent a full endoscopic inter-laminar approach for total excision of the cyst. Postoperatively, the patient's symptoms resolved, without cyst recurrence or instability at 1 year.

Conclusion: Endoscopic total excision of giant synovial cysts is a surgical option that can effectively address symptoms while minimizing the risk of segmental instability. This case demonstrates the feasibility and benefits of this minimally invasive approach.