Aim: Synovial cysts are relatively common in the lumbar spine and very uncommon in the cervical spine. Several case reports and a few small series have been reported in the literature over the past four decades. There are two distinct cervical spine synovial cyst categories: atlantoaxial and the subaxial cervical spine. The surgical treatments are very different.
Material and methods: We report eleven patients undergoing transoral resection and posterior fusion for histologically confirmed symptomatic atlantoaxial synovial cysts. This represents a retrospective review over 18 years. The authors analyzed the literature of patients who underwent surgical treatment for symptomatic atlantoaxial synovial cysts.
Results: There were four male and seven female patients with a mean age of 76 years (range 54-84 years). All patients presented with cervical myelopathy. Patients were neurologically assessed pre- and postoperatively and outcome reported using the Modified Rankin Outcome score. Mean follow-up period was 22 months (range 6-120 months). Ten of the eleven patients had improvement in their postoperative assessment and one patient remained unchanged.
Conclusion: Myelopathy is the presenting symptom in the vast majority of these patients. Surgical resection and decompression of the neural structures can be an effective treatment for symptomatic atlantoaxial synovial cysts.