显微手术治疗骶管Tarlov囊肿

Microsurgical treatment of sacral Tarlov cysts

目的探讨骶管Tarlov 囊肿(骶管囊肿)临床特点和手术治疗。方法回顾性分析25例有症状的骶管囊肿临床和影像学特点。结果术后早期25例中21例症状缓解。24例随访3～48个月(平均18月),囊肿未见复发。19例患者症状消失或明显改善,5例仍存在疼痛及麻木不适感,不影响生活及工作。结论对有明确症状的骶管囊肿患者应采取显微手术治疗。手术方式根据骶管囊肿的不同类型,采取囊肿交通孔结扎囊壁切除,或囊肿大部切除神经袖套塑形的方法,并采取带蒂脂肪填塞囊肿切除后遗留的残腔。

Objective To explore the clinical features and surgical treatment of symptomatic Tarlov cysts. Methods The clinical data of 25 patients with symptomatic Tarlov cysts in our department were analyzed retrospectively. Results In early postoperative period, surgical treatment gave pain relief in 21 out of 25 patients. No complications were observed. 24 patients were followed up from 3 to 48 months with an average of 18 months without cysts recurrence. Of 24 patients, 19 experienced complete or substantial resolution of the preoperative local and radicular pain after surgery ,5 still complained of mild pain and numbness but could be tolerated well without influence to daily life. Conclusion Microsurgery is recommended to symptomatic Tarlov cysts. Surgery procedures, including excision of the cyst combined with direct dural closure or partial cyst excision and plication of the cyst wall, should be selected according to different types of cysts.