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- Tsitsopoulos, Parmenion PUppsala University Hospital (author)
Management of symptomatic sacral perineural cysts with microsurgery and a vascularized fasciocutaneous flap
- Article/chapterEnglish2018
Publisher, publication year, extent ...
- 2018-09
- AME Publishing Company,2018
- printrdacarrier
Numbers
- LIBRIS-ID:oai:DiVA.org:uu-397514
- https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-397514URI
- https://doi.org/10.21037/jss.2018.07.02DOI
- https://lup.lub.lu.se/record/fbf93925-a74e-487f-9bc8-bbd2d5de102dURI
Supplementary language notes
- Language:English
- Summary in:English
Part of subdatabase
- SwePubSwePub
Classification
Notes
- Background: The optimal treatment of symptomatic perineural (Tarlov) cysts is controversial. Numerous surgical techniques have been proposed with conflicting results. A series of Tarlov cysts treated with a novel surgical approach is presented.Methods: Patients with surgically treated symptomatic perineural cysts during 2013-2016 were included. The main indications for surgery were persistent radicular symptoms, pelvic pain, urinary and/ or bowel disturbances. At surgery, the cyst was opened and fenestrated. The cyst wall was then closed with packing, fibrin glue and a pedicled vascularized fasciocutaneous flap rotated into the area for obliteration of the dead space. Patients were followed-up with clinical visits and repeat magnetic resonance imaging (MRI) scans.Results: Seven consecutive patients were included. The mean age was 50.3 years (range, 25-80 years) and the mean duration of symptoms was 49.3 months (range, 3-130 months). With one exception, all patients had urine and/or bowel problems (incontinence) preoperatively. A lumbar drain was inserted in five patients. The mean follow-up period was 15.4 months. Symptoms improved in 4/7 patients, in two cases no clinical difference was noted while one patient deteriorated. In two cases, a spinal cord stimulator was eventually implanted. In all seven cases, a significantly decreased cyst size was noted on MRI.Conclusions: Cyst fenestration and the use of a vascularized fasciocutaneous flap successfully obliterated all cysts, with satisfactory clinical efficacy. Larger and comparative studies are warranted to clarify the long-term effects of this surgical technique in patients with symptomatic Tarlov cysts.
Subject headings and genre
- MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kirurgi hsv//swe
- MEDICAL AND HEALTH SCIENCES Clinical Medicine Surgery hsv//eng
- Perineural sacral cysts
- Tarlov cysts
- complications
- fasciocutaneous flap
- muscle flap
- outcome
- surgical management
Added entries (persons, corporate bodies, meetings, titles ...)
- Marklund, NiklasLund University,Lunds universitet,Neurokirurgi,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurosurgery,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Uppsala University Hospital(Swepub:lu)ni0588ma (author)
- Salci, Konstantin (author)
- Holtz, Anders (author)
- Mani, MariaUppsala universitet,Plastikkirurgi,Uppsala University Hospital(Swepub:uu)maman192 (author)
- Uppsala University HospitalNeurokirurgi (creator_code:org_t)
Related titles
- In:Journal of spine surgery (Hong Kong): AME Publishing Company4:3, s. 602-6092414-469X2414-4630
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