Cervical juxtafacet cyst combined with spinal dysraphism

Abstract

Juxtafacet cysts of the cervical and thoracic spine are rare and often cause radiculopathy or myelopathy. We present a case of a patient with radicular pain and early onset myelopathy. A juxtafacet cyst at the cervico-thoracic junction combined with discal herniation and spina bifida occulta was diagnosed with computed tomography (CT) and magnetic resonance imaging (MRI). Laminectomy with removal of the cyst was the treatment and the patient recovered rapidly.

Introduction

Synovial cysts, usually referred to as juxtafacet cysts [1], are uncommon intraspinal lesions. They occur most frequently in the lumbar spine and rarely in the cervico-thoracic region. They develop most often near the articular facet or in the yellow ligament. The most likely origin of the cysts is a herniation of the synovial lining from the chronically overloaded facet joint. These cysts are associated with chronic spinal degeneration. Juxtafacet cysts may cause a radicular compression syndrome mimicking disc herniation, rarely acute spinal cord compression or cauda equina compression in the lumbar region [2], [3], [4].

They are diagnosed by characteristic findings on CT or MRI scan [5], [6], [7].

This article reports a male patient with a juxtafacet cyst causing radicular pain followed by the development of myelopathy. Our case is a rarity, because it presents a cervico-thoracic cyst combined with discus herniation and spina bifida occulta.