INTRACYSTIC HEMORRHAGE IN THE LUMBAR SPINE AS A CAUSE OF SUDDEN LEG WEAKNESS – A CASE REPORT

Vekoslav Mitrović; Vladimir Baščarević; Radojica Stolić; Vladimir Mitrović; Snežana Filipović-Danić

doi:10.5937/sanamed0-51878

Vekoslav Mitrović University of East Sarajevo, Faculty of Medicine Foča, Republic of Srpska, Bosnia and Herzegovina
Vladimir Baščarević Clinical Center of Serbia, Clinic for Neurosurgery, Belgrade, Serbia
Radojica Stolić University of Kragujevac, Faculty of Medical Sciences, Department of Internal Medicine, Kragujevac, Serbia
Vladimir Mitrović University of Priština – Kosovska Mitrovica, Faculty of Medicine, Serbia
Snežana Filipović-Danić University of Priština – Kosovska Mitrovica, Faculty of Medicine, Serbia

DOI: https://doi.org/10.5937/sanamed0-51878

Keywords: synovial cysts, bleeding, leg weakness

Abstract

Introduction: Synovial cysts of the facet joint are rare benign changes occurring in the spinal synovial joints, predominantly in the lumbar region. Although these cysts are generally benign, intracystic hemorrhages are extremely rare and can lead to severe complications.

Case Presentation: This case report details a patient who developed cauda equina syndrome due to hemorrhage within a synovial cyst in the lumbar spine.The patient's symptoms included acute radicular pain and neurological deterioration. Diagnostic imaging revealed a large synovial cyst with evidence of intracystic bleeding.

Conclusion: Acute radicular pain and rapid neurological deterioration can result from a synovial cyst in the lumbar spine, particularly when complicated by intracystic bleeding. Urgent decompressive surgery and removal of the cyst resulted in complete recovery for the patient.

References

Ruiz-Picazo D, Ramírez-Villaescusa J, Verdejo-González A. An unusual case of radicular pain caused by bilateral lumbar synovial cyst: a case report and review of the literature. Case Rep Orthop. 2020;2020:8821332. doi: 10.1155/2020/8821332.

Bodian C, Davis J, Hadlow A. Traumatic haemorrhagic lumbar synovial facet cyst presenting as bilateral foot drop: a case report. N Z Med J. 2018;131(1478):62-4.

Liawrungrueang W, Deevijit C, Bunmaprasert T. Can acute radiculopathy be caused by upper lumbar hemorrhagic synovial cyst spinal compression in the elderly? Int J Surg Case Rep. 2022;93:107002. doi: 10.1016/j.ijscr.2022.107002.

Kalevski SK, Haritonov DG, Peev NA. Lumbar intraforaminal synovial cyst in young adulthood: case report and review of the literature. Global Spine J. 2014; 4(3): 191-6. doi: 10.1055/s-0034-1370694.

Sincari M, Carvalho A, Nunes A, Sincari MD. Lumbar Synovial Cyst, Literature Review: Challenges of the Surgical Management, the Role of Minimal Invasive Techniques and Endoscopy. Surgical Science. 2023; 14(11): 681-93.doi: 10.4236/ss.2023.1411074 .

Cannarsa G, Clark SW, Chalouhi N, Zanaty M, Heller J. Hemorrhagic lumbar synovial cyst: case report and literature review. Nagoya J Med Sci. 2015;77(3):481-92.

Giordan E, Gallinaro P, Stafa A, Canova G, Zanata R, Marton E, et al. A systematic review and meta-analysis of outcomes and adverse events for juxtafacet cysts treatment. Int J Spine Surg. 2022; 16(1): 124-38. doi: 10.14444/8181.

Terzic Z, Radonjic D, Paunovic M, Ljaljevic A, Bojic M. Large solitary encapsulated neurofibroma of upper arm – a case report. Sanamed. 2022; 17(1): 33-6.doi: 10.5937/sanamed17-36810.

Scrofani R, De Simone M, Migliorini F, Amoroso E, Maffulli N, Narciso N, et al. Spontaneous resolution of symptomatic synovial cysts of the lumbar spine: a comprehensive review with two illustrative cases. Medicina. 2024; 60(7):1115. doi:10.3390/medicina60071115.