Synovial Spinal Cyst Rupture/Aspiration

Synovial cyst rupture and aspiration is a minimally invasive procedure designed to reduce pain caused by a synovial spinal cyst pressing on nerves. The treatment relieves nerve compression and inflammation, providing significant pain relief for conditions like radiculopathy.

What is a Synovial Cyst Rupture/Aspiration?

  • Synovial Cyst: A fluid-filled sac that forms near the facet joints of the spine, often due to arthritis or wear-and-tear.

  • Rupture/Aspiration Procedure: Involves draining (aspiration) or rupturing the cyst to reduce nerve compression and relieve pain.

What conditions does it treat?

  • Nerve Compression (Radiculopathy)

  • Facet Joint-Associated Pain

Benefits of Cyst Rupture

  • Immediate Relief: Reduces nerve compression and associated pain.

  • Minimally Invasive: Avoids the need for open surgery.

  • Quick Recovery: Patients often resume normal activities within a few days.

Preparation & Post-Care

  • Before: Stop certain medications directed by your provider, fast for 3 hours, and arrange a driver if sedated.

  • After: Avoid vigorous activities and submerging the injection site for 24 hours. Relief is commonly reported within 7 days. Report any increased pain or swelling to your provider.

    1. Preparation: IV access is placed for conscious sedation. Local anesthetic numbs the skin to minimize discomfort.

    2. Needle Placement: Using X-ray guidance, needles are inserted.

    3. Contrast Dye Injection: Contrast dye ensures correct needle placement and medication flow.

    4. Rupture/Aspiration: The cyst is ruptured with a saline flush or aspirated with suction.

    5. Steroid Injection: A mixture of anesthetic and steroid is injected to reduce inflammation and prevent cyst recurrence.

    6. Recovery: IV and needles are removed, and a small bandage is applied. You will need someone to drive you home.

  • Discontinue the following medications:

    • Lovenox (enoxaparin) 12-24 hours prior to procedure

    • Integrilin (eptifibatide) 1 day prior to procedure

    • Aggrastat (tirofiban) 1 day prior to procedure

    • Pletal (cilostazol) 2 days prior to procedure

    • Trental (pentoxifylline) 2 days prior to procedure

    • Eliquis (apixaban) 3 days prior to procedure

    • Savaysa (edoxaban) 3 days prior to procedure

    • Xarelto (rivaroxaban) 3 days prior to procedure

    • Pradaxa (dabigatran) 3 days prior to procedure

    • Arixtra (fondaparinux) 4 days prior to procedure

    • Aspirin 5 days prior to procedure

    • Warfarin (coumadin) 5 days prior to procedure

    • Reopro (abciximab) 5 days prior to procedure

    • Brilinta (ticagrelor) 5 days prior to procedure

    • Aggrenox (dipyridamole) 7 days prior to procedure

    • Plavix (clopidogrel) 7 days prior to procedure

    • Effient (prasugrel) 7 days prior to procedure

    • Ticlid (ticlopidine) 14 days prior to procedure

    • Medication: Stop blood thinners and specific medications as directed by your provider.

    • Fasting: Avoid eating for 3 hours before the procedure; clear liquids are allowed up to 1 hour before.

    • Allergies: Inform your doctor if you’re allergic to latex, adhesives, anesthetics, steroids, or contrast dye.

    • Arrange Transport: If sedation is used, plan for someone to drive you home.

  • Avoid submerging the injection site in water for 24 hours and limit vigorous activities. Report any increased pain or swelling to your provider.

  • While the procedure provides relief, recurrence is possible. Follow-up treatments or surgery may be required in some cases.

This video explains what a synovial cyst is and common treatments.