Limits...
Symptomatic lumbosacral perineural cysts: A report of three cases and review of literature.

Sharma M, Velho V, Mally R, Khan SW - Asian J Neurosurg (2015 Jul-Sep)

Bottom Line: Two of our patients had symptoms of cauda equina syndrome, and one had acute sciatica.Symptomatic lumbosacral Tarlov's cyst is a rare lesion, and the presentation can be low back pain, cauda equina syndrome or sciatica.Therefore, this entity should be kept in the differential diagnosis of patients presenting with these symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Grant Medical College and Sir J. J. Group of Hospitals, Mumbai, Maharashtra, India.

ABSTRACT
Lumbosacral perineural cysts (Tarlov's cysts) are nerve root cysts, which are usually asymptomatic and are detected incidentally on imaging. These cysts are rare with an incidence of 4.6%. We report three cases of Lumbosacral Tarlov's cysts, which presented with cauda equina syndrome and radicular pain syndrome. Two of our patients had symptoms of cauda equina syndrome, and one had acute sciatica. Complete excision of the cyst was achieved in two patients and marsupialization of the cyst was done in another patient due to its large size and dense adherence to the sacral nerve roots. All the patients were relieved of the radicular pain with no new neurological deficit following surgery. Symptomatic lumbosacral Tarlov's cyst is a rare lesion, and the presentation can be low back pain, cauda equina syndrome or sciatica. Therefore, this entity should be kept in the differential diagnosis of patients presenting with these symptoms. Complete Surgical excision of these symptomatic cysts is the treatment of choice to achieve a cure.

No MeSH data available.


Related in: MedlinePlus

Magnetic resonance imaging scan (T2 weighted sequence, axial view) of the lumbosacral spine showing a well-defined cystic lesion along the traversing left L5-S1 nerve root suggestive of perineural cyst
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4553737&req=5

Figure 3: Magnetic resonance imaging scan (T2 weighted sequence, axial view) of the lumbosacral spine showing a well-defined cystic lesion along the traversing left L5-S1 nerve root suggestive of perineural cyst

Mentions: A 28-year-old female presented with pain in both lower limbs for the last 2 years. The pain was more in the left lower limb and aggravated since last 6 months. It was associated with numbness on the lateral aspect of left lower limb. On examination, higher mental functions were normal. Power was normal at both knees and hips but the power of both extensor halluces longus/flexor halluces longus was reduced and movement was possible only against less than normal resistance (4/5 according to Medical Research Council Scale). Pain and temperature sensations were diminished along left L5-S1 dermatome by 50%. Ankle reflex was diminished on the left side. The rest of the reflexes were normal, and both the plantar reflexes were down going. X-ray of the lumbosacral spine was suggestive of spondylolysis of pars interarticularis of L5. MRI (T2-weighted) of the lumbosacral spine showed a well-defined cystic lesion along the traversing left L5-S1 nerve root similar to case 1 [Figure 3]. Electromyography and nerve conduction studies were suggestive of chronic partial denervation with reinnervation in left L5 and S1 dermatome. Left L4-S1 laminectomy was done, and complete excision of the cyst was achieved. The cyst was thin walled and translucent. The content of the cyst was CSF.


Symptomatic lumbosacral perineural cysts: A report of three cases and review of literature.

Sharma M, Velho V, Mally R, Khan SW - Asian J Neurosurg (2015 Jul-Sep)

Magnetic resonance imaging scan (T2 weighted sequence, axial view) of the lumbosacral spine showing a well-defined cystic lesion along the traversing left L5-S1 nerve root suggestive of perineural cyst
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4553737&req=5

Figure 3: Magnetic resonance imaging scan (T2 weighted sequence, axial view) of the lumbosacral spine showing a well-defined cystic lesion along the traversing left L5-S1 nerve root suggestive of perineural cyst
Mentions: A 28-year-old female presented with pain in both lower limbs for the last 2 years. The pain was more in the left lower limb and aggravated since last 6 months. It was associated with numbness on the lateral aspect of left lower limb. On examination, higher mental functions were normal. Power was normal at both knees and hips but the power of both extensor halluces longus/flexor halluces longus was reduced and movement was possible only against less than normal resistance (4/5 according to Medical Research Council Scale). Pain and temperature sensations were diminished along left L5-S1 dermatome by 50%. Ankle reflex was diminished on the left side. The rest of the reflexes were normal, and both the plantar reflexes were down going. X-ray of the lumbosacral spine was suggestive of spondylolysis of pars interarticularis of L5. MRI (T2-weighted) of the lumbosacral spine showed a well-defined cystic lesion along the traversing left L5-S1 nerve root similar to case 1 [Figure 3]. Electromyography and nerve conduction studies were suggestive of chronic partial denervation with reinnervation in left L5 and S1 dermatome. Left L4-S1 laminectomy was done, and complete excision of the cyst was achieved. The cyst was thin walled and translucent. The content of the cyst was CSF.

Bottom Line: Two of our patients had symptoms of cauda equina syndrome, and one had acute sciatica.Symptomatic lumbosacral Tarlov's cyst is a rare lesion, and the presentation can be low back pain, cauda equina syndrome or sciatica.Therefore, this entity should be kept in the differential diagnosis of patients presenting with these symptoms.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurosurgery, Grant Medical College and Sir J. J. Group of Hospitals, Mumbai, Maharashtra, India.

ABSTRACT
Lumbosacral perineural cysts (Tarlov's cysts) are nerve root cysts, which are usually asymptomatic and are detected incidentally on imaging. These cysts are rare with an incidence of 4.6%. We report three cases of Lumbosacral Tarlov's cysts, which presented with cauda equina syndrome and radicular pain syndrome. Two of our patients had symptoms of cauda equina syndrome, and one had acute sciatica. Complete excision of the cyst was achieved in two patients and marsupialization of the cyst was done in another patient due to its large size and dense adherence to the sacral nerve roots. All the patients were relieved of the radicular pain with no new neurological deficit following surgery. Symptomatic lumbosacral Tarlov's cyst is a rare lesion, and the presentation can be low back pain, cauda equina syndrome or sciatica. Therefore, this entity should be kept in the differential diagnosis of patients presenting with these symptoms. Complete Surgical excision of these symptomatic cysts is the treatment of choice to achieve a cure.

No MeSH data available.


Related in: MedlinePlus