Symptomatic epidural hematoma caused by lumbar synovial cyst rupture: report of two cases and review of the literature.

OBJECTIVE AND

IMPORTANCE

Juxtafacet cysts of the lumbar spine are a recognized cause of back pain, radicular symptoms, neurogenic claudication, and, less often, cauda equina compression syndrome. Hemorrhagic rupture of a juxtafacet cyst and the resulting epidural hematoma may cause chronic and/or acute cauda equina compression.

CLINICAL PRESENTATION: We report two cases of ruptured hemorrhagic lumbar synovial cysts resulting in epidural hematoma and progressive symptomatic cauda equina compression.

INTERVENTION: Surgical excision of the epidural hematoma and the associated cyst resulted in complete resolution of symptoms.

CONCLUSION

Rarely, juxtafacet cysts of the lumbar spine may rupture and hemorrhage into the epidural space causing symptomatic cauda equina compression. It is important to consider this entity when evaluating the patient with cauda equina compression. The findings of these cases give insight into the clinical presentation, operative treatment, and outcome in these patients.