Article
Operative treatment of symptomatic sacral cysts: a study of 19 cases
Operative Therapie von symptomatischen sakralen Zysten: eine Studie mit 19 Fällen
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Authors
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J. Weber
- Neurochirurgische Klinik, Leopoldina KH, Schweinfurt
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A. Spring
- Neurochirurgische Klinik, Leopoldina KH, Schweinfurt
| Published: | April 11, 2007 |
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Outline
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Objective: There are very few data in the literature regarding the role of sacral cysts in causing sympotms. Most studies report low numbers, and consequently, the recommendations for treatment are vague. In this retrospective study, the efficacy of microsurgical partial cyst wall resection is evaluated and the long-term outcome is described.
Methods: Over a 15-year period, 19 patients underwent operation for sacral cysts. We performed sacral decompression with microsurgical cyst fenestration and partial cyst wall resection, and reinforced the closures with epidural fat and fibrin glue application. MRI, CT, and myelography were performed in all cases. The average follow-up was 6,8 years (range 1 to 15 years) after surgery.
Results: Clinical symptoms such as pain and sensory deficits improved in 15 patients after the operation. Bladder control improved markedly for 4 of the 5 patients with bladder dysfunction. The correlation of cyst size, sacral erosion, and the communication with the subarachnoid space (CT-myelography) did not provide predictive information concerning operative outcome. Only young age (<50 years) and a short history of symptoms (<1 year) correlate with good outcome. There were no cerebrospinal fluid leaks and no new postoperative neurological deficits.
Conclusions: Approximately 80% of microsugical partial cyst wall resections of symptomatic sacral cysts are effective treatments for long-term relief of symptoms. No imaging modality could predict the value of surgical intervention.
