Recurring lumbar cysts

[Calamityme]

Hello. I had surgery for decompression of L4/L5 stenosis Feb 2011. After a couple of weeks started getting symptoms again to find by MRI that cysts had appeared in the space created. Had surgery to remove them Dec 2011. Again they have come back, pain is worse but on the other side and having nerve/numbness problems. Where do I go from here, is there an alternative way to be treated? Has anyone else had the same thing?

[angelsforme22]

I have been diagnosed with 10cm x 13cm x 10 cm synovial cyst on left SI. However my right leg is getting weak and numb. My neurosurgeron would prefer I follow with pain mgt group for aspiration of cyst. She does not want to excise even though she had performed L5-S1 fusion about 5 years ago. Insurance does not want to pay for arthroplasty of SI joints because it is deemed investigational. I am going through hoops trying to get a dr to try to remove the cyst and find out if I have more since it is giving me a lot of pain. Could you please advise me on how to get through the red tape?  Thanks.

[Calamityme]

Many thanks for your response, it is much appreciated. I have met with my neurosurgeon and he does not want to do anything more, he told me he thinks the cysts are not causing the pain/problems. I have been passed on to the pain clinic (a long wait). I am considering having a second opinion, privately, to save time.Many thanks for your advice. I will enquire about the options you suggested when I get to see someone.  

[Dr Sharma]

Hello and welcome to the medhelp forum. Synovial cysts usually form in the lumbar portion of the spine when degenerative diseases like arthritis affects the facet joints in the spine. These affect the spinal stability apart from the pressure and compression symptoms, which you are having. The excessive synovial fluid production is formed because of the degenerative process and forms a synovial cyst pressing on the nerve roots within the spinal canal. You have undergone multiple surgical decompression but with recurrence. You could discuss with your neurosurgeon the possibility of cyst aspiration under imaging visualization, associated with recurrence. Steroid injections can be given into the facet joint or the space surrounding the cyst to reduce the associated inflammation. Consult your neurosurgeon immediately since you have bladder bowel symptoms indicating lumbar spinal stenosis. Wishing you all the best.