Question: Is Fusion Right for a Synovial Cyst?

Had 2 back surgeries to remove a synovial cyst @ L4 and L5 on right side (in 2000 and 2002). The surgeries were to remove the cyst only. Now, I still have pain in my back, hip, butt and leg. Right leg cramps up and feels dead and numb. I also started having pain on my left side and is starting to go down my left leg.

Recent MRI showed: bony 38; discogenic degenerative changes at L4-5 with moderate to severe proximal foraminal stenosis on left and moderate right sided foraminal stenosis.

Do you think a fusion is in order? What type of Dr. - neuro or orthopedic? I tried everything!

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Doctor’s Response: Most Patients With Synovial Cysts Eventually Require Spinal Fusion

In general, I have found patients who have had a synovial cyst will eventually require a spine fusion. This is not always true, but it is fairly common that a fusion will be required. I believe this is the case because the synovial cyst comes off the facet joint as it degenerates.

Although a decompression can remove the cyst, the facet joint degeneration continues, and this eventually leads to instability at the affected joint. Either an orthopedic surgeon or neurosurgeon can perform this type of surgery.

The best situation is to find a surgeon who has done a spine fellowship and/or concentrates their practice on spine fusions.

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In Spine-health’s Doctor Advice section, physicians respond to frequently asked questions about back pain issues. These responses represent the opinion of one physician, and do not necessarily reflect the views of the broader medical community. The advice presented has not been peer reviewed by Spine-health’s medical advisory board.