Inflammatory factors may also play an important role in the development of synovial cysts, with upregulation of angiopoeitin-1, basic fibroblastic growth factor, substance P, platelet-derived growth factor, and interleukins at the site of the mechanically stressed facet joints contributing to synovial hyperplasia and leading to cyst formation 15). It is thought that they start with facet joint degenerative change and erosion that extended through the wall of the joint capsule, triggered by hypermobility 7, 15) or due to a traumatic event 15, 16). The cause of synovial cysts in the cervical spine is multifactorial, but remains uncertain. Since synovial cysts occur most frequently in the lumbar spine, symptomatic cases are much more commonly seen in those affecting the lumbar spine compared with the cervical spine 14). Based on histologic analysis, it is lined internally with a cuboid or pseudostratified columnar epithelium and contains clear fluid 10). Spinal synovial cyst is defined as an extradural extrusion of the synovium through a capsular defect from a degenerate or unstable facet joint 13). Key words: Cervical vertebrae Hemorrhage Synovial cysts
![synovial cyst on spine synovial cyst on spine](http://thepainsource.com/wp-content/uploads/2012/09/Large-LEFT-L45-synovial-facet-cyst-on-T2-weighted-MRI-sagittal-and-axial-views.jpg)
We present a case of lower cervical (C7-T1) synovial cyst with acute bleeding and sudden increase in the size of the lesion with spinal cord compression as well as a review of literature. The patient’s neurological condition slowly improved to stick-assisted gait after the surgical decompression.
![synovial cyst on spine synovial cyst on spine](http://spinesurgeon.sydney/wp-content/uploads/2017/01/synovialcyst4.jpg)
The histology showed a hemorrhagic synovial cyst. Intra operative examination revealed that the mass contained a hematoma.
![synovial cyst on spine synovial cyst on spine](https://els-jbs-prod-cdn.jbs.elsevierhealth.com/cms/attachment/2035029456/2050320453/gr1.jpg)
A cervical laminectomy and removal of the mass were performed. The spine magnetic resonance imaging revealed a heterogeneously enhanced mass which has compressed the spinal cord posteriorly at the C7-T1 level. A 74-year-old woman presented with a 1-year history of bilateral leg weakness that has worsened within the recent couple of weeks. Traumatic or non-traumatic origins of acute bleeding into the cyst cavity resulting in cyst enlargement and epidural compression have been reported. Synovial cysts of the cervical spine are rare entities and intra-cystic hemorrhage have been described in a few of these cases.