An MRI showed junctional stenosis and a synovial cyst. Stephen R. Goll, M.D., one of the board-certified orthopaedic surgeons at Orlando Orthopaedic Center, specializes in complex spinal surgeries. In 2008, with Dr. Goll’s help, Ginny underwent surgery to correct these issues. She fully recovered and is pleased with the results. Today she says, “The biggest benefit from this is that I get to work full time–I can even work out on my Bowflex and have a great, busy, playful life with my husband, Tim.”
When he diagnosed Ginny with junctional stenosis and a synovial cyst, Dr. Goll realized that he would have to treat two diagnoses at the same time. The diagnoses that Ginny suffered from can be broken down into:
- Junctional stenosis
- Synovial cyst (in the L3-4 Left portion of the spine)
Junctional stenosis is “one of the greatest challenges in spinal deformity surgery.” The condition causes a narrowing of the hollow cavity within the spinal column at a juncture between the bones. To understand this, you must first understand that the spine is hollow and functions as a support column for the entire structure of our bodies.
Your spine resembles a long tube that runs from the base of your skull to your tailbone. 31-pairs of nerves run throughout the structure and carry signals from the brain to the rest of the body. When the bony spinal structure develops stenosis, it begins to narrow. This narrowing can pinch and put pressure on the nerves.
The spinal column is one of the most difficult areas of the body to repair because of the complexity of the structure. Ginny’s diagnosis was particularly challenging to treat because she developed synovial cyst syndrome in addition to junctional stenosis.
A synovial cyst can cause spinal stenosis when the fluid-filled sac develops around the spine, slowly pinching off the vital structures in the column. It often occurs in older patients and is almost always located in the lower part of the spine.
The final part of Ginny’s diagnosis includes the term “L3-L4,” which refers to the location of the spinal degeneration. The L3-L4 segment of the spine is located in the lumbar area of the spinal column, which forms the lower back. While the spinal column itself is a hollow tube, on the back of the column are vertebral bones and intervertebral discs, along with blood vessels, ligaments, nerves, and muscles. There are 33 stacked bones along the spine and each vertebra is numbered. Together, this series of interlocking bones allow you to move freely. Between each bone are shock absorbers called intervertebral discs. The L3-4 segment of the spine controls the structure in the lower lumbar back region, which bears the full weight of the body. When you lift something heavy with your back (and not your knees), your lumbar spine absorbs the added stress.
Symptoms of these conditions include:
- Leg, calve, or buttock numbness
- Calf cramps when walking
- Pain that radiates into both legs and thighs
- Weakness in these areas
Now that you understand Ginny’s diagnosis, you may wonder how these problems developed. Both conditions resulted in the slow deterioration of Ginny’s spinal column, causing numbness and tingling in these areas. But what causes this type of spinal degeneration?