Cervical Facet Cyst Causing Progressive Paraplegia: A Case Report and Review of Literature

ABSTRACT

STUDY DESIGN: A case report and literature review. OBJECTIVES: To report a patient with a cervical facet cyst causing progressive paraplegia, and to review the clinical features, treatment and outcomes of a cervical facetal cyst. SUMMARY OF LITERATURE REVIEW: Extradural intraspinal synovial cysts of the cervical spine are quite rare. They typically occur in the cervical region at the C1-C2 junction or in the space adjacent to the facet joints in the lower cervical spine, and show similar clinical features to the intervertebral disc protrusion. MATERIALS AND METHODS: This article reports a case of a male patient, 64 years old, who presented with a 2 day history of numbness below the nipple and progressive paraplegia. A physical examination at admission revealed a wheelchair ambulatory state due to a motor deficit (motor grade good) below both hip flexors. Magnetic resonance imaging of the cervical spine showed an extradural lesion with a left lateral extension between C7 and T1, causing spinal cord compression. The patient underwent a hemi-laminectomy of C7 and complete cyst excision through the posterior approach. His motor power improved to almost normal. RESULTS: The patient showed good recovery of myelopathy, and he was able to walk with a cane 3 months after surgery. A 1 year follow-up did not reveal any recurrence or new neurological conditions. CONCLUSION: Cervical facet cysts are rare lesions that are occasionally signaled by progressive paraplegia but can be treated successfully by a surgical excision.