Dehaine V, Wechsler B, Ziza J M, de Gennes C, Robain G, Fohanno D, Metzger J, Godeau P
Service de médecine inteme, Groupe hospitalier Pitié-Salpêtrière, Paris.
Rev Med Interne. 1990 Jul-Aug;11(4):280-4. doi: 10.1016/s0248-8663(05)80858-6.
In a 63-year old male patient coccygodynia, initially isolated then complicated by incomplete cauda equina syndrome, could be attributed to large perineurel meningeal cysts on the sacral nerve roots. The diagnosis was suspected at computerized tomography and nuclear magnetic resonance and confirmed by sacculoradiculography. Intradural injections of corticosteroids provided lasting pain relief. Arachnoid cysts are often asymptomatic, by they may be responsible for coccygodynia and/or incomplete cauda equina syndrome. Their presence is suggested by the characteristics of the symptoms which are paroxysmal, exacerbated in standing position, relieved in dorsal position and revived by percussing the sacrum. Treatment is medical in most cases. The decision to operate depends on the persistence and intensity of pain and on whether signs of neurological defecit are present.
在一名63岁男性患者中，尾骨痛最初单独出现，随后并发不完全马尾综合征，这可能归因于骶神经根上的大的神经束膜性脑脊膜囊肿。计算机断层扫描和核磁共振检查怀疑了该诊断，并通过囊状神经根造影得以证实。硬膜内注射皮质类固醇提供了持久的疼痛缓解。蛛网膜囊肿通常无症状，但它们可能导致尾骨痛和/或不完全马尾综合征。症状的特点提示其存在，这些症状是阵发性的，站立时加重，卧位时缓解，且敲击骶骨时复发。大多数情况下采用药物治疗。是否手术取决于疼痛的持续时间和强度以及是否存在神经功能缺损的体征。
