A case report and literature review.

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.

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.

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 hemilaminectomy of C7 and complete cyst excision through the posterior approach. His motor power improved to almost normal.

The patient showed good recovery of myelopathy, and he was able to walk with a cane 3 months after surgery. A 1 year followup did not reveal any recurrence or new neurological conditions.

Cervical facet cysts are rare lesions that are occasionally signaled by progressive paraplegia but can be treated successfully by a surgical excision.