Spinal synovial cysts are a rare cause of radiculopathy and neurologicaldeficits. When treatment of these lesions is necessary surgicalapproaches have been proven more efficient compared withconservative or invasive interventions. Despite that, there are stilluncertainties over the optimal surgical method. It is our belief thata gross total cystectomy should be performed through the lessinvasive approach available and in order to sustain spinal stability.Of course, further prospective randomized trials, longer follow upperiods and larger cohorts are necessary to address the issue.