[Operative treatment of symptomatic nerve root cysts]

Nerve root cysts are often asymptomatic and show a predilective manifestation for the lumbo-sacral spine. Depending on their size and the anatomic relationship to the nerve roots they may cause symptoms such as pain or even neurological deficits. From the therapeutical point of view, different moldalities of intervention are controversially discussed because the clinical importance of this entity is still unclear. There are curative as well as symptomatic therapeutic options. The curative therapy includes surgical excision of the cyst and duraplasty whereas the symptomatic therapy is limited to drainage of the cyst. The purpose of this study was to evaluate the role of surgical excision of the cyst with duraplasty using microsurgical techniques.

This study included 13 patients who suffered from pain and neurological deficits with myelographically and MRI proven sacral nerve root cysts. All patients underwent surgery for cyst excision plus duraplasty.

Clinical symptoms such as pain and sensory deficits significantly improved in all patients postoperatively. 85 % of the patients showed a full recovery from the previously existing radicular pain and motoric as well as sensory deficits. All patients reported a significant improvement of their preoperative loss in muscle strength.

Surgical excision combined with duraplasty using microsurgical techniques has proven to be the method of choice in the treatment of symptomatic sacral nerve root cysts.