Spinal Cysts - Types, Diagnosis, and Treatment

What Is a Spinal Cyst?

A cyst is a small sac-like structure filled with gas, fluid, or cheesy white material. It can form anywhere in the body. Rarely, a cyst may develop on some part of the spine. The majority of spinal cysts are completely harmless. However, the formation of cysts on certain specific areas of the spine may cause back pain or other symptoms. Spinal cysts are a relatively uncommon condition and generally develop in individuals over fifty. If the symptoms start troubling the affected individual, they should be treated by various methods.

What Are the Types of Spinal Cysts One May Develop?

Depending on the origin, location, and the substance filled inside the cyst, it can be:

• Synovial Cyst - They are the most common type of spinal cyst. And one may develop a synovial cyst, mostly in the spine's lower back (lumbar region). Doctors believe it is formed due to age-related wear and tear in the spinal bone joints, such as osteoarthritis. This is the region of the spine that helps one twist and bend.

• Ganglion Cyst - Ganglion cysts may form in any part of the body, especially in the joints. Basically, it is a fluid-filled sac attached to the tendons (tissue that attaches muscles to bones) in a joint. Rarely may one develop a ganglion cyst within the bony joints of the spine.

• Arachnoid Cyst - The brain and spinal cord are covered and protected by three layers of membranes called the meninges. The spider web-like middle layer is known as the arachnoid layer. Very rarely, a cyst may be formed between these layers around the spinal cords, known as an arachnoid cyst. It will be filled with cerebrospinal fluid (clear fluid in which the brain and spinal cord are suspended). It may form in the neck region (cervical), upper back (sacral), or lower back (lumbar) region of the spinal cord.

• Tarlov Cyst - It is a fluid-filled cyst that may become symptomatic. A Tarlov cyst often develops at the base of the spine next to the nerve roots starting from the spinal cord. It can compress the nerves next to it and cause pain and weakness. Tarlov cysts should be treated on time; otherwise, they may cause irreparable damage to the nerves.

When Does a Spinal Cyst Turn Out to Be Troublesome?

A stack of bones called vertebrae forms the spine. Each vertebra is attached to the next one with an intervertebral disk. It is a rubbery substance that acts as a cushion to protect the spine from impacts. The hollow portion inside the vertebrae holds and protects the spinal cord. The spinal cord is an extension of the brain completely made up of nerve cells. It extends to the bottom of the ribcage. And it sends out numerous nerves to every part of the body. These nerves send messages back and forth to the brain. That is how one can move around, perform activities at will and perceive different sensations from all over the body. A cyst may form at any part of the length of the spine. But if it is positioned in a manner where it compresses the spinal cord, one may suffer several symptoms.

What Are the Symptoms Associated With Spinal Cysts?

In most individuals, spinal cysts are asymptomatic, meaning they do not cause any health issues. The symptoms of spinal cysts may be similar to that of herniated disks or arthritis of vertebral joints pushing down onto the spinal cord. The typical symptoms associated with spinal cysts would include a combination of the following:

1. Back pain.

2. Buttock pain.

3. Leg pain.

4. The pain may be felt only on one side of the body.

5. One may experience a lack of strength and pain in the arms and legs due to compression of the nerve.

6. There may be numbness and tingling on the affected parts.

7. Changing postures like sitting, standing, or moving around make the pain worse.

8. Lose bowel and bladder control.

How Are Spinal Cysts Diagnosed?

Most of the time, spinal cysts go undetected as they do not cause any harm to the individual. Often, they come across as a surprise finding on an imaging study conducted to visualize the spine for some other cause. However, if one experiences the symptoms mentioned above, the doctor may look into the possible presence of a spinal cyst. The doctor will listen to all the symptoms on their duration, nature, the pattern of pain, and weakness, and if the pain has worsened over time, one may also conduct the following:

• Neurological Examination - To assess the functional level of nerves and muscles. One may test the strength, movements, response to various simulations, balance, and overall coordination to evaluate functional impairment at any body part.

• Imaging Studies - The doctor may order an X-ray of the spine to rule out other structural abnormalities. However, a magnetic resonance imaging (MRI) study is the easiest way to make the diagnosis of a spinal cyst or any problem in the spine in general. It gives a great visualization of the spinal structures and anything that might be going on in the spinal canal. The spinal cyst in question may appear as a bubble-like structure anywhere on the length of the spinal canal.

What Is the Treatment for Spinal Cysts?

A harmless cyst may be left as it is. But if it causes nerve compression and symptoms like pain and numbness, the doctor may adopt the following treatments:

1. Adequate rest and intake of painkillers may relieve the symptoms. One may choose to wait and observe the cyst till it heals on its own.

2. One may have to routinely drain the fluid from the cyst and shrink it to avoid nerve compression.

3. Minimally invasive techniques, where the cyst is ruptured through an injection. Under sedation and X-ray guidance, one may rupture or puncture the cyst with a needle. The patient can leave the facility approximately thirty minutes after the procedure and return to work.

4. Surgery is normally chosen as the last option. The procedure is done through a small cut into the spinal column, and a surgical instrument is slipped in to remove the cyst.

Conclusion:

When one has a spinal cyst with troublesome symptoms, one must seek treatment. A multidisciplinary team involving neurologists, surgeons, radiologists, and physical therapists, will be able to take care of it better. Early diagnosis and intervention are key to determining a spine diagnosis if one suffers back pain or neck pain from the cyst. Also, for getting conservative treatment, one may avoid surgical intervention. The entire team can work together and discuss among the doctors and the patient what is the best option for them.