Sacral nerve root cysts manifesting as localized unilateral perineal pain--case report

A 62-year-old female presented with multiple sacral nerve root cysts manifesting as localized unilateral perineal pain. Myelography just after contrast material injection revealed multiple cysts at the sacral level. However, perioperative dye injection showed hardly any flow in the reverse direction. Only the S3 nerve was constricted by hyperplasia of the dura mater, and adhered to the cyst wall. Other nerves were not constricted, nor adhered to cyst walls. The S3 nerve constriction and tight adhesion was the cause of the pain. The one-way flow of spinal fluid from the spinal subarachnoid space to the cysts is probably closely correlated with cyst formation.