Abstract
BackgroundThere has been no consensus on the optimal treatment of symptomatic sacral perineural cysts. Most previous reports concerning the management methods were either sporadic case reports or a series of limited cases. This study is to further optimize the management for patients with symptomatic sacral perineural cysts by analyzing the outcomes of a cohort of patients who were treated with different strategies.Methods and FindingsWe reviewed the outcomes of 15 patients with symptomatic sacral perineural cysts who were managed by three different modalities from 1998 through 2010. Six patients underwent microsurgical cyst fenestration and cyst wall imbrication. Seven patients underwent a modified surgical procedure, during which the cerebrospinal fluid leak aperture was located and repaired. Two patients were treated with medication and physical therapy. Outcomes of the patients were assessed by following up (13 months to 10 years). All of the six patients treated with microsurgical cyst fenestration and cyst wall imbrication experienced complete or substantial relief of their preoperative symptoms. However, the symptoms of one patient reappeared eight months after the operation. Another patient experienced a postoperative cerebrospinal fluid leakage. Six of the seven patients treated with the modified surgical operation experienced complete or substantial resolution of their preoperative symptoms, with only one patient who experienced temporary worsening of his preoperative urine incontinence, which disappeared gradually one month later. No new postoperative neurological deficits, no cerebrospinal fluid leaks and no recurrence were observed in the seven patients. The symptoms of the two patients treated with conservative measures aggravated with time.ConclusionsMicrosurgical operation should be a treatment consideration in patients with symptomatic sacral perineural cysts. Furthermore, the surgical procedure with partial cyst removal and aperture repair for prevention of cerebrospinal fluid leakage seemed to be more simple and effective.
Highlights
Sacral perineural cysts, which were termed Tarlov cysts, are collections of cerebrospinal fluid (CSF) between the endoneurium and perineurium of the nerve root sheath near the dorsal root ganglion [1]
There has been no consensus on the optimal treatment of symptomatic sacral perineural cysts since it was first described by Tarlov in 1938 [4]
Between 1998 and 2010, 15 patients ranging from 23 to 60 years of age with symptomatic sacral perineural cysts were treated at General Hospital of Fengfeng Group (Table 1),whose follow-up is more than one year
Summary
Sacral perineural cysts, which were termed Tarlov cysts, are collections of cerebrospinal fluid (CSF) between the endoneurium and perineurium of the nerve root sheath near the dorsal root ganglion [1]. These lesions are quite common as an incidental finding on magnetic resonance imaging (MRI), and most of them are asymptomatic [2]. Many methods have been applied to treat these symptomatic lesions, with variable results. This study is to further optimize the management for patients with symptomatic sacral perineural cysts by analyzing the outcomes of a cohort of patients who were treated with different strategies
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
