Synovial Cyst Decompression

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?.A synovial cyst is a fluid filled lesion that arises from a degenerated facet joint (arthritis) of the spine. Using state-of-the art CT imaging guidance, we can localize these cysts and attempt to decompress and fenestrate them with a needle. When accessible not every cyst will drain but if it is accessible and drainable, open surgery can be avoided temporarily and in some instances completely.


Need to Know

Nice to Know
  • If you take blood thinners, such as Coumadin, or other medications, your doctor may instruct you to stop taking your medication for a period of time before the procedure.
  • Inform your physician if you are pregnant.
  • Inform your physician of any allergies to contrast material
  • You will need a driver to bring you and take you home
  • You will be awake during the procedure lying on your stomach
  • You can go home after the procedure
  • You may be given a gown to wear during the procedure


How Does It Work?

With the guidance of ultrasound imaging (a painless exam which uses high-frequency sound waves to produce real time images ), your doctor will insert a tiny needle to draw fluid out from behind your knee and shrink or remove the Baker’s cyst.

What Happens — Before, During, and After?

You will lie on your stomach on the exam table for this procedure.. Your doctor will then give you a shot of local anesthesia to numb the area. You will feel a small pinch as the anesthesia is administered.

The target lesion is precisely localized by advancing the needle under CT image guidance and confirmed with a test injection of contrast material. Only after the location is precisely identified is the lesion aspirated/decompressed. Steroid medication and lidocaine are also administered to treat associated inflammation. The needle is removed, skin cleaned and a standard band-aid applied.

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How Should I Prepare?

There are things you can do to make your experience more comfortable, and many of these will depend on your individual preferences. You might like to keep a list of questions or — as you’re doing now — educate yourself about the procedure.

Some other things to keep in mind in planning for this procedure include:

  • You will need a driver to bring you and take you home
  • Your doctor may ask you to stop taking aspirin, non-steroidal anti-inflammatory drugs (NSAIDS), or blood thinners (such as Coumadin or warfarin) for a time before the procedure
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What Should I Bring?

On the day of your procedure you should:

  • Wear comfortable, loose-fitting clothes
  • Wear comfortable, shoes
  • Avoid bringing jewelry or valuables
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What Are the Benefits and Risks?

The benefits of a synovial cyst decompression could be:

  • Relief of pain
  • Reduced inflammation which may lead to healing
  • Some risks you should be aware of include:
  • As with any procedure there is a slight risk of infection
  • Rarely, this procedure can cause a temporary increase in pain
  • Rarely there are reactions to the medication such as rash or hot flashes
  • There is a slight risk of nerve damage at the injection site
  • There is a slight risk of bleeding

Keep in mind that this information is general. Your radiologist is the best source of information about how these risks and benefits may apply to you.

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