Surgical treatment of symptomatic sacral cysts: report of 5 cases

Sacral cysts are collections of cerebrospinal fluid (CSF) between the endoneurium and the perineurium of the sacral nerve root sheath. Surgery is recommended for large cysts with symptoms attributable to them. We report 5 patients with symptomatic sacral cysts treated at our institution, including 1 male and 4 females with an average age of 51.8 years (range, 36-66 years). Surgical intervention included posterior laminectomy, direct excision of the cysts and repair, and replication or cover of the dura defect by sutures or biomaterials. Pathologic examination disclosed cystic lesions with a fibrous wall without an inner arachnoid lining. All patients recovered and remained symptom-free for 39.6 months (range, 30-51 months). Treatment methods for symptomatic sacral cysts vary. Direct decompression and cyst excision are effective methods with highly successful rates and expectations.