Kunz U, Mauer U M, Waldbaur H
Armed Forces Hospital, Department of Neurosurgery, Ulm, Germany.
Eur Spine J. 1999;8(3):218-22. doi: 10.1007/s005860050161.
No critical discussion of the indication for the surgical treatment of lumbosacral extradural arachnoid cysts is found in the literature. Therefore, we want to compare the results in patients with operative and conservative treatment to define standards for a good surgical result. Over a period of 9 years, we operated on eight patients with a lumbosacral extradural arachnoid cyst and treated eight others conservatively. Only three of the operated patients experienced a postoperative relief of pain, but none was symptom free. The only one with continuing success had a preoperative history of 1 year only. MRI scans without contrast agent were misinterpreted in one included and one excluded case. The results of conservative treatment were nearly the same as those of operative treatment. MRI is the best diagnostic tool, but a variety of sequences must be used. Patients with a short pain history and a clear neurological deficit profited most from surgery. Patients with slight and not clearly related uncharacteristic symptoms should be excluded from surgery.
文献中未发现对腰骶部硬膜外蛛网膜囊肿手术治疗适应证的批判性讨论。因此，我们想比较手术治疗和保守治疗患者的结果，以确定良好手术效果的标准。在9年的时间里，我们对8例腰骶部硬膜外蛛网膜囊肿患者进行了手术，并对另外8例进行了保守治疗。只有3例手术患者术后疼痛得到缓解，但无一例症状完全消失。唯一持续取得成功的患者术前病史仅1年。1例纳入病例和1例排除病例中未使用造影剂的MRI扫描结果被误判。保守治疗的结果与手术治疗的结果几乎相同。MRI是最好的诊断工具，但必须使用多种序列。疼痛病史短且有明确神经功能缺损的患者从手术中获益最大。有轻微且与特征不明显症状无明确关联的患者应排除在手术之外。
