Surgical Excision of Symptomatic Sacral Cyst: A Case Report

手術切除法治療有症狀表現之薦椎囊腫：個例報告

洪瑞國(Jui-Kuo Hung) ； 胡仲行(Chung-Hsing Hu)

《The Changhua Journal of Medicine》 7卷4期 (2002/10) Pp. 244-249

摘要

薦椎囊腫是一種源於薦椎神經根的囊腫。雖然大多數病例是沒有症狀的，但若囊腫大到足以引起臨床症狀的時候，藉由手術方法以達到減壓的目的，仍然是必要的。本文報告一位五十四歲女性，主訴下背痛合併放射至右下肢已有三個月的時間，後來並産生右側第五腰椎及第一、二薦椎神經皮節的感覺異常。X-光片檢查顯示第四、五腰椎第一度退化性滑脫，磁振造影在第一至第三薦椎處發現－於T2磁序呈現高度訊號的囊腫。手術方法是施行第一至第三薦椎的椎弓切除，並將源於右側第二薦椎神經根的囊腫完全切除。術後半年病患恢復情況良好。

關鍵字

薦椎囊腫 ； Tarlov囊腫 ； 神經根 ； 椎弓切除術 ； 切除

並列摘要

Spinal perineural cysts, or Tarlov cysts, are lesions of the nerve root that are mostly found in the sacral region. Although many are asymptomatic, surgery is recommended for the treatment of symptomatic large cysts. We present a 54-year-old woman with the initial symptom of low back pain radiating to the lateral aspect of her right thigh and calf for 3 months. She was treated for degenerative spondylolisthesis of L4 on L5 and for right L5 radiculopathy. The symptoms improved after conservative treatments. However, intolerable pain and paresthesia over the perianal area developed 1 month later. Magnetic resonance imaging revealed a cystic lesion at the sacrum from SI to S3. Laminectomy of S1 to S3 was performed with excision of the cyst. The histopathologic examination showed a cystic lesion with a fibrous wall. The patient recovered and remained symptom-free for 6 months after the operation.

並列關鍵字

sacral cyst ； Tarlov cyst ； nerve root ； laminectomy ； excision