A, Sagittal T2-weighted MR image reveals a large left L4–5 synovial cyst causing moderate central canal stenosis and compression of the exiting left L4.

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AUTHORS: Y Kumar, K Hooda, D Hayashi, N Parikh, S Sharma, M Meszaros Yale New Haven Health System at Bridgeport Hospital Bridgeport, CT USA ASNR 2015 Abstract.

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Presentation transcript:

A, Sagittal T2-weighted MR image reveals a large left L4–5 synovial cyst causing moderate central canal stenosis and compression of the exiting left L4 nerve root, corresponding to the patient's radicular symptoms and neuroclaudication episodes. A, Sagittal T2-weighted MR image reveals a large left L4–5 synovial cyst causing moderate central canal stenosis and compression of the exiting left L4 nerve root, corresponding to the patient's radicular symptoms and neuroclaudication episodes. B, CT is used to localize the facet and reveals large overhanging osteophytes limiting joint access. C, CT guidance is then used for a left sublaminar approach. D, Rapid forceful injection of contrast into the cyst is performed; epidural spread of contrast confirms cyst rupture. The patient's pain scale was 8/10 preprocedure and 2/10 postprocedure. J.L. Bykowski, and W.H.W. Wong AJNR Am J Neuroradiol 2012;33:1419-1426 ©2012 by American Society of Neuroradiology