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Management of sympt...
Management of symptomatic sacral perineural cysts with microsurgery and a vascularized fasciocutaneous flap
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- Tsitsopoulos, Parmenion P (författare)
- Uppsala University Hospital
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- Marklund, Niklas (författare)
- Lund 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
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Salci, Konstantin (författare)
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Holtz, Anders (författare)
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- Mani, Maria (författare)
- Uppsala universitet,Plastikkirurgi,Uppsala University Hospital
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(creator_code:org_t)
- 2018-09
- 2018
- Engelska.
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Ingår i: Journal of spine surgery (Hong Kong). - : AME Publishing Company. - 2414-469X .- 2414-4630. ; 4:3, s. 602-609
- Relaterad länk:
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https://doi.org/10.2...
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http://dx.doi.org/10...
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https://urn.kb.se/re...
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https://doi.org/10.2...
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https://lup.lub.lu.s...
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Abstract
Ämnesord
Stäng
- 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.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Perineural sacral cysts
- Tarlov cysts
- complications
- fasciocutaneous flap
- muscle flap
- outcome
- surgical management
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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