Intradural synovial cyst of the upper cervical spine: A rare cause of symptomatic cord compression
Bibliographic record
Abstract
BACKGROUND: Synovial cysts are commonly observed soft-tissue masses of the spine, typically extradural and located in the lumbar region. We describe a very rare symptomatic case of a C1-C2 intradural synovial cyst. CASE DESCRIPTION: A 78-year-old female presented with progressive left side weakness, paresthesia, and hyperreflexia. The magnetic resonance imaging revealed a well-circumscribed, subtly enhancing lesion medial to the C1-2 facet, causing cord compression and edema. Using neurophysiological monitoring, surgery included a modified laminectomy of C2 with the removal of the C1 posterior arch. When the dura was opened, a sizable intradural extramedullary lesion was encountered, the cyst was successfully drained and partially resected. The histopathological diagnosis was consistent with a synovial cyst. Postoperatively, the patient's strength on the left side improved gradually until she was fully ambulatory. Postoperative imaging showed no recurrence at 8 months follow-up. CONCLUSION: Synovial cysts should be considered among the differential diagnose of C1-2 cysts. They can occur intradurally and compress the spinal cord resulting in a significant neurological deficit. Cyst excision may be accomplished utilizing a limited laminectomy for cyst identification and drainage, accompanied by partial resection of the cyst wall. Such intervention can lead to good clinical outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".