Teaching NeuroImages: Cervical synovial cyst leading to spinal cord compression

Cervical synovial cysts are an uncommon degenerative finding that can lead to spinal canal stenosis, myelopathy, and radiculopathy.1 Here we present the radiographic findings of a synovial cyst in a patient presenting with progressively worsening bilateral upper and lower extremity weakness. It is seen to cause prominent uplifting of the posterior longitudinal ligament and furthermore significant central canal stenosis (figure). CT-guided needle aspiration may provide symptomatic relief though frequently resulting in reoccurrence due to preservation of an intact synovium. Definitive treatment is surgical and may consist of laminoplasty, laminectomy, and in severe instances, spinal fusion.2