{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:15:42Z","timestamp":1760145342941,"version":"build-2065373602"},"reference-count":42,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T00:00:00Z","timestamp":1720483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Although lumbar synovial cysts (LSCs) are frequently described in the literature, they are a relatively uncommon cause of low back and radicular leg pain. Furthermore, their spontaneous resolution is an even rarer event. The standard treatment of the lumbar synovial cyst is surgical excision. Spontaneous resolution in the literature is a sporadic event. In our experience, we have had two cases where the lumbar synovial cyst disappeared spontaneously. To date, only nine cases of spontaneous resolution of synovial cysts have been documented in the literature. In this discussion, we highlight a pathology that typically suggests surgical intervention, yet conservative treatment can be a viable alternative. We present two cases of large synovial cysts that were initially scheduled for surgery but ultimately resolved spontaneously without any treatment. While the spontaneous resolution of lumbar synovial cysts is extremely rare, conservative strategies are an option that should not be overlooked. Our cases contribute to the growing body of evidence on the spontaneous regression of symptomatic LSC, potentially enhancing the understanding of the disease\u2019s natural progression in the future.<\/jats:p>","DOI":"10.3390\/medicina60071115","type":"journal-article","created":{"date-parts":[[2024,7,9]],"date-time":"2024-07-09T13:22:36Z","timestamp":1720531356000},"page":"1115","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Spontaneous Resolution of Symptomatic Synovial Cysts of the Lumbar Spine: A Comprehensive Review with Two Illustrative Cases"],"prefix":"10.3390","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8700-0198","authenticated-orcid":false,"given":"Raffaele","family":"Scrofani","sequence":"first","affiliation":[{"name":"Department of Clinical Neurosurgery, AOU San Giovanni di Dio e Ruggi D\u2032Aragona, University of Salerno, Via San Leonardo 1, 84131 Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8172-6134","authenticated-orcid":false,"given":"Matteo","family":"De Simone","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, Via S. Allende, 84081 Baronissi, Italy"},{"name":"BrainLab s.r.l., Mercato San Severino, 84085 Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7220-1221","authenticated-orcid":false,"given":"Filippo","family":"Migliorini","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH University Hospital, 52074 Aachen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ettore","family":"Amoroso","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosurgery, AOU San Giovanni di Dio e Ruggi D\u2032Aragona, University of Salerno, Via San Leonardo 1, 84131 Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Maffulli","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, Faculty of Medicine and Psychology, University of Rome \u201cLa Sapienza\u201d, 00185 Rome, Italy"},{"name":"School of Pharmacy and Bioengineering, Keele University School of Medicine, Thornburrow Drive, Stoke on Trent ST5 5BG, UK"},{"name":"Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Queen Mary University of London, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Narciso","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosurgery, AOU San Giovanni di Dio e Ruggi D\u2032Aragona, University of Salerno, Via San Leonardo 1, 84131 Salerno, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6924-3551","authenticated-orcid":false,"given":"Giorgio","family":"Iaconetta","sequence":"additional","affiliation":[{"name":"Department of Clinical Neurosurgery, AOU San Giovanni di Dio e Ruggi D\u2032Aragona, University of Salerno, Via San Leonardo 1, 84131 Salerno, Italy"},{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, Via S. Allende, 84081 Baronissi, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,7,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1097\/00003086-199402000-00001","article-title":"On the formation of synovial cysts in the leg in connection with disease of the knee-joint. 1877","volume":"299","author":"Baker","year":"1994","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"372","DOI":"10.3171\/jns.1974.41.3.0372","article-title":"Synovial cyst of spinal facet. Case report","volume":"41","author":"Kao","year":"1974","journal-title":"J. Neurosurg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1055\/s-0034-1370694","article-title":"Lumbar intraforaminal synovial cyst in young adulthood: Case report and review of the literature","volume":"4","author":"Kalevski","year":"2014","journal-title":"Glob. Spine J."},{"key":"ref_4","first-page":"193","article-title":"Intraspinal synovial cysts: 10-year experience at the Ochsner Clinic","volume":"91","author":"Howington","year":"1999","journal-title":"J. Neurosurg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"449","DOI":"10.3171\/jns.1994.81.3.0449","article-title":"Hemorrhage into a lumbar synovial cyst causing an acute cauda equina syndrome. Case report","volume":"81","author":"Tatter","year":"1994","journal-title":"J. Neurosurg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"560","DOI":"10.3171\/jns.1996.85.4.0560","article-title":"A series of 60 juxtafacet cysts: Clinical presentation, the role of spinal instability, and treatment","volume":"85","author":"Sabo","year":"1996","journal-title":"J. Neurosurg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"288","DOI":"10.4103\/0028-3886.63788","article-title":"Diagnosis and surgical management of intraspinal hemorrhagic juxtafacet cysts in lumbar spine: Experience of eight cases","volume":"58","author":"Gong","year":"2010","journal-title":"Neurol. India"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1044","DOI":"10.1097\/BRS.0b013e3181bdafed","article-title":"Factors associated with recurrent back pain and cyst recurrence after surgical resection of one hundred ninety-five spinal synovial cysts: Analysis of one hundred sixty-seven consecutive cases","volume":"35","author":"Xu","year":"2010","journal-title":"Spine"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1176","DOI":"10.1007\/s00586-005-0009-4","article-title":"Spinal lumbar synovial cysts. Diagnosis and management challenge","volume":"15","author":"Khan","year":"2006","journal-title":"Eur. Spine J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"35","DOI":"10.2478\/raon-2013-0024","article-title":"Minimally invasive CT guided treatment of intraspinal synovial cyst","volume":"48","author":"Kozar","year":"2014","journal-title":"Radiol. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1111\/his.13465","article-title":"Histopathology of synovial cysts of the spine","volume":"72","author":"Chebib","year":"2018","journal-title":"Histopathology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1007\/s10143-012-0443-9","article-title":"True synovial cysts of the lumbar spine: An epiphenomenon of instability of the functional spine unit?","volume":"36","author":"Mattei","year":"2013","journal-title":"Neurosurg. Rev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s10143-011-0356-z","article-title":"Microsurgical excision without fusion as a safe option for resection of synovial cyst of the lumbar spine: Long-term follow-up in mono-institutional experience","volume":"35","author":"Landi","year":"2012","journal-title":"Neurosurg. Rev."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"256","DOI":"10.3171\/2016.12.SPINE16756","article-title":"Synovial cysts of the spine: Long-term follow-up after surgical treatment of 141 cases in a single-center series and comprehensive literature review of 2900 degenerative spinal cysts","volume":"27","author":"Bruder","year":"2017","journal-title":"J Neurosurg Spine"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3910","DOI":"10.1177\/0300060518781694","article-title":"Micro-endoscopic discectomy versus percutaneous endoscopic surgery for lumbar disk herniation","volume":"46","author":"Abudurexiti","year":"2018","journal-title":"J. Int. Med. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"453","DOI":"10.3171\/2012.8.SPINE12101","article-title":"Minimally invasive resection of lumbar synovial cysts from a contralateral approach","volume":"17","author":"Rhee","year":"2012","journal-title":"J. Neurosurg. Spine"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/S1529-9430(03)00148-7","article-title":"Lumbar intraspinal synovial cysts: Conservative management and review of the world\u2019s literature","volume":"3","author":"Shah","year":"2003","journal-title":"Spine J."},{"key":"ref_18","first-page":"235","article-title":"Spontaneous regression of symptomatic lumbar synovial cysts. Report of three cases","volume":"99","author":"Houten","year":"2003","journal-title":"J. Neurosurg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"186","DOI":"10.3171\/spi.2006.4.2.186","article-title":"Spontaneous resolution of a cervical synovial cyst","volume":"4","author":"Colen","year":"2006","journal-title":"Case illustration. J. Neurosurg. Spine"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.wneu.2011.06.034","article-title":"Management of lumbar spine juxtafacet cysts","volume":"77","author":"Bashir","year":"2012","journal-title":"World Neurosurg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1186\/1749-799X-2-5","article-title":"Microdecompression for lumbar synovial cysts: An independent assessment of long term outcomes","volume":"2","author":"Weiner","year":"2007","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0070-2153(06)79001-9","article-title":"The development of synovial joints","volume":"79","author":"Khan","year":"2007","journal-title":"Curr. Top. Dev. Biol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1097\/00007632-200405010-00018","article-title":"Lumbar laminectomy for the resection of synovial cysts and coexisting lumbar spinal stenosis or degenerative spondylolisthesis: An outcome study","volume":"29","author":"Epstein","year":"2004","journal-title":"Spine"},{"key":"ref_24","first-page":"14","article-title":"Synovial cysts of the lumbar spine: Surgery-related results and out come","volume":"99","author":"Pirotte","year":"2003","journal-title":"J. Neurosurg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"969","DOI":"10.1097\/00007632-200104150-00024","article-title":"Patient outcome after resection of lumbar juxtafacet cysts","volume":"26","author":"Banning","year":"2001","journal-title":"Spine"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s007010170117","article-title":"Juxtafacet cyst of the lumbar spine. Clinical, radiological and therapeutic aspects in 28 cases","volume":"143","author":"Salmon","year":"2001","journal-title":"Acta Neurochir."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1136\/jnnp.70.1.74","article-title":"Diagnosis and surgical management of intraspinal synovial cysts: Report of 19 cases","volume":"70","author":"Trummer","year":"2001","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"203","DOI":"10.3109\/17453679909011263","article-title":"Lumbar nerve root compression by intraspinal synovial cysts. Report of 8 cases","volume":"70","author":"Jonsoon","year":"1999","journal-title":"Acta Orthop. Scand."},{"key":"ref_29","first-page":"989","article-title":"Experience with symptomatic spinal epidural cysts","volume":"34","author":"Freidberg","year":"1994","journal-title":"Neurosurgery"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.wneu.2019.04.091","article-title":"Resolution of Symptomatic Lumbar Synovial Cyst after Traumatic Event","volume":"128","author":"Nordmann","year":"2019","journal-title":"World Neurosurg."},{"key":"ref_31","first-page":"1","article-title":"Spontaneous resolution of symptomatic lumbar synovial cyst","volume":"10","author":"Sinha","year":"2016","journal-title":"J. Surg. Case Rep."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"123","DOI":"10.3109\/02688697.2011.595847","article-title":"Spontaneous resolution of a symptomatic synovial cyst of the lumbar spine","volume":"26","author":"Pulhorn","year":"2012","journal-title":"Br. J. Neurosurg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1055\/s-2005-858823","article-title":"MRT follow-up study of spontaneous regression of lumbar articular facet cyst","volume":"177","author":"Illerhaus","year":"2005","journal-title":"Rofo"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/S0028-3770(06)71193-6","article-title":"Resolution of a synovial cyst of the lumbar spine without surgical therapy\u2014A case report","volume":"52","author":"Ewald","year":"2005","journal-title":"Zentralbl Neurochir."},{"key":"ref_35","first-page":"1261","article-title":"Spontaneous Resolution of an intraspinal synovial cyst","volume":"24","author":"Swartz","year":"2003","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s005860050016","article-title":"Spontaneous remission of a solitary intraspinal synovial cyst of the lumbar spine","volume":"9","author":"Maezawa","year":"2000","journal-title":"Eur. Spine J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1007\/BF00339570","article-title":"Intraspinal synovial cyst: Diagnosis by CT. Follow-up and spontaneous remission","volume":"27","author":"Mercader","year":"1985","journal-title":"Neuroradiology"},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"De Simone, M., Conti, V., Palermo, G., De Maria, L., and Iaconetta, G. (2023). Advancements in Glioma Care: Focus on Emerging Neurosurgical Techniques. Biomedicines, 12.","DOI":"10.3390\/biomedicines12010008"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Benato, A., Menna, G., Rapisarda, A., Polli, F.M., D\u2019Ercole, M., Izzo, A., D\u2019Alessandris, Q.G., and Montano, N. (2023). Decompression with or without Fusion for Lumbar Synovial Cysts-A Systematic Review and Meta-Analysis. J. Clin. Med., 12.","DOI":"10.3390\/jcm12072664"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1186\/s40001-023-01481-0","article-title":"Efficacy of minimally invasive tubular approaches for management of the lumbar spinal synovial cysts: A meta-analysis","volume":"28","author":"Chen","year":"2023","journal-title":"Eur. J. Med. Res."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"De Simone, M., Iaconetta, G., Palermo, G., Fiorindi, A., Schaller, K., and De Maria, L. (2024). Clustering Functional Magnetic Resonance Imaging Time Series in Glioblastoma Characterization: A Review of the Evolution, Applications, and Potentials. Brain Sci., 14.","DOI":"10.3390\/brainsci14030296"},{"key":"ref_42","first-page":"851","article-title":"Creation and validation of a predictive model for lumbar synovial cyst recurrence following decompression without fusion. Journal of neurosurgery","volume":"37","author":"Page","year":"2022","journal-title":"Spine"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/7\/1115\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T15:12:09Z","timestamp":1760109129000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/60\/7\/1115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,9]]},"references-count":42,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2024,7]]}},"alternative-id":["medicina60071115"],"URL":"https:\/\/doi.org\/10.3390\/medicina60071115","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2024,7,9]]}}}