漏口内口封堵并带蒂肌瓣填塞治疗症状性骶管囊肿的疗效分析

Microsurgical treatment for symptomatic sacral cysts(report of 26 ceses)

目的探讨漏口内口封堵并带蒂肌瓣填塞治疗症状性骶管囊肿的疗效。方法回顾性分析2017年9月至2018年2月收治的26例症状性骶管囊肿的临床资料。手术在电生理监测下进行,显微镜下切开硬脊膜囊底部,寻找囊肿漏口于硬膜囊内的起始处,即漏口内口,自体小块肌肉封堵内口,囊肿残腔行带蒂肌瓣填塞。结果26例术后随访22~27个月,平均24.5个月。21例症状改善明显或完全消失,5例自觉症状减轻。术后无脑脊液漏。术后3个月至半年内复查MRI,未见囊肿复发。结论内口封堵并带蒂肌瓣填塞治疗症状性骶管囊肿,简单安全,远期疗效好,可有效降低术后复发率。

Objective To introduce a surgical procedure termed blocking the inlet of fistula and filling the cyst and to analyze its curative effect on symptomatic sacral cysts.Methods The clinical data of 26 patients with symptomatic sacral cysts who underwent surgery from September 2017 to February 2018 were retrospectively analyzed.The operation was performed under electrophysiological monitoring.The bottom of the dura sac was cut under the microscope to find the inlet of fistula in the dural sac and then filling the cyst with pedicled muscle flaps.These 26 patients were followed up for 22 to 27 months,with an average of 24.5 months.Results The MRI examination 3~6 months after the surgery showed no cyst recurred.Of 26 patients,21 patients were remarkably improved or completely recovered,and 5 alleviated after the operation.There was no cerebrospinal fluid leakage after the operation.Conclusions The surgical procedure termed blocking the inlet of fistula and filling the cyst,which has long-term curative effect and can effectively reduce the recurrence rate,is a simple and safe way for symptomatic sacral cysts.