I am considering removal of a synovial cyst on my L4-L5, the pain has become unbearable and miserable and 2 epidural shots have not helped. This is my second time having this, after 3 shots last time, I had 18 months of relief but this time it s worse and I know they will keep recurring. What are the risks and details of surgery and the recovery plan and timing?
Hi there, welcome to Chat Doctor, thanks for your question Synovial cysts are fluid filled soft tissue structures which are formed due to degeneration in the joints between bones of your back (known as facet joints between L4 and L5. I. e 4th and 5th spinal bone in your situation). These cysts get filled like a balloon filled with water when you stand or walk and get deflated when you rest or lie down due to decompression like a deflated balloon. Since they lie in proximity to the nerves in your spine, they are associated with pain radiating down the leg, similar to sciatica pain seen with disc herniation During early stages when the cysts are small, the pain can respond to steroid injections which help in reducing the inflammation associated witChatDoctorpression of the never. But once the cases reach a certain size the mechanical compression of nerves become significant and atop responding to injections. At this stage surgery is indicated. Surgical options include only decompression or decompression with fusion with screws. Whether to use screws and fuse or not will depend on assessment for instability of the bones at the involved level by X-rays/CT scan or MRI.However, most commonly most of the synovial cysts in spine respond cert well to decompression surgery wit encouraging results. Hope this answers your question. All the best with best regards Chat Doctor. 