Surgical treatment of arachnoid cysts in sacral canal:analysis of 23 cases / 中国矫形外科杂志

ABSTRACT

Objective: To study characteristics of diagnosis and treatment of arachnoid cysts in the sacral canal. Method: After laminectomy of the sacral canal, arachnoid cysts were treated in three ways 13 cases underwent excision of the most of the cyst wall and suture of redundant wall around the intracystic nerve; 8 cases underwent the excision of the most of the cyst wall and plugging the communicating hole with a block of muscle; 2 cases underwent excision of most of the cyst wall and leaving them unsutured. Clinical results were evaluated after 30. 2 months' follow-up. Changes in the imaging materials (X-ray, CT, CTM and MRI) were also evaluated. The clinical behaviors, pathologies and complications post-operatively were analyzed. Result: Long T1 and T2 signals of the cysts could be clearly showed in MRI, and the signal density was the same as that of cerebrospinal fluid. Clinical symptoms were caused by compression of sacral nerve. Generally, there were communicating holes between cysts and thecal sacs. There were no statistical differences between first two methods of treatments. The complications post-operatively included erosion of wound skin and intracranial infection. Conclusion: MRI allows us to better illustrate the arachnoid cyst in sacral canal, and the cyst seems to arise as a result of congenital defect of thecal dura. Excision of the most of the cyst wall and plugging the communicating hole with a block of muscle seems to to a reasonable method to treat the carachnoid cysts in the sacral canal. Do not put the drain tube and forbidding patients to lie supinely are better for reducing the complications.