Sacral perineural cyst accompanying disc herniation.
Chang Il Ju1, Ho Shin, Seok Won Kim
1Department of Neurosurgery, School of Medicine, Chosun University, Gwangju, Korea.
Journal of Korean Neurosurgical Society
|April 9, 2009
Summary
Sacral perineural cysts can cause S1 radiculopathy. A cyst-subarachnoid shunt effectively relieved persistent leg pain and hypesthesia after initial discectomy failed.
Area of Science:
- Neurosurgery
- Neurology
- Radiology
Background:
- Sacral perineural cysts (SPCs) are typically asymptomatic.
- However, symptomatic SPCs can cause radicular pain due to nerve root compression.
- This case highlights a rare instance of S1 radiculopathy linked to an SPC.
Observation:
- A patient presented with persistent right leg pain and hypesthesia, initially attributed to a herniated disc at L5-S1.
- Microscopic discectomy provided no relief.
- A sacral perineural cyst was identified as a contributing factor.
Findings:
- Surgical intervention involved a cyst-subarachnoid shunt to decompress the S1 nerve root.
- The shunt also aimed to equalize cerebrospinal fluid pressure between the thecal sac and the cyst.
- The patient experienced immediate and sustained relief from leg pain post-shunt placement.
Implications:
- Cyst-subarachnoid shunting is an effective treatment for radiculopathy caused by SPCs when discectomy is insufficient.
- This case underscores the importance of considering SPCs in the differential diagnosis of persistent radicular pain.
- Accurate diagnosis and targeted intervention can significantly improve patient outcomes in complex spinal conditions.
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