Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Neurospine Center, China International Neuroscience Institute, Beijing, China.
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Neurospine Center, China International Neuroscience Institute, Beijing, China.
World Neurosurg. 2022 Feb;158:e598-e604. doi: 10.1016/j.wneu.2021.11.019. Epub 2021 Nov 11.
To examine the surgical procedure for and the clinical efficacy of using spinal endoscopy for sacral Tarlov cyst treatment.
A retrospective analysis of patients with sacral Tarlov cysts who underwent spinal endoscopy treatment from August 2018 to January 2020 at the Department of Neurosurgery, Xuanwu Hospital, China, was carried out.
Spinal endoscopy treatment was performed in 15 patients with sacral Tarlov cysts (6 males, 9 females). Mean patient age was 41.3 years (range, 19-67 years). Mean follow-up period was 15.6 months (range, 12-26 months). Clinical presentations of patients included sacrococcygeal and lower limb pain (n = 14), paresthesia (n = 7), lower limb motor disorder (n = 1), bowel dysfunction (n = 4), and urinary dysfunction (n = 3). Surgeries were successfully completed in all patients. Pain was significantly alleviated after surgery in 12 (85.7%) patients. Visual analog scale scores before surgery, at 1 day and 3 months after surgery, and at last follow-up were 5.9 ± 1.2, 2.9 ± 1.5, 2.3 ± 1.3, and 2.6 ± 1.0. The postoperative visual analog scale scores were significantly decreased compared with the preoperative score (all P < 0.01). Among the patients with paresthesia, 4 (57.1%) experienced improved symptoms. Muscle strength recovered from grade 4 to grade 5 after surgery in 1 patient with lower limb motor disorder. Two (50%) of 4 patients with bowel dysfunction and 2 (66.7%) of 3 patients with urinary dysfunction experienced functional improvement. Postoperative magnetic resonance imaging showed that cyst filling was satisfactory, and cyst recurrence was not observed.
Spinal endoscopy shows preliminary clinical efficacy for treatment of sacral Tarlov cysts and is safe and effective.
探讨应用脊柱内镜治疗骶管 Tarlov 囊肿的手术方法及临床疗效。
回顾性分析 2018 年 8 月至 2020 年 1 月中国宣武医院神经外科收治的 15 例骶管 Tarlov 囊肿患者的临床资料，均采用脊柱内镜治疗。
15 例骶管 Tarlov 囊肿患者中，男 6 例，女 9 例；年龄 19～67 岁，平均 41.3 岁；随访 12～26 个月，平均 15.6 个月。临床表现为骶尾部及下肢疼痛 14 例，下肢麻木 7 例，下肢运动障碍 1 例，排便功能障碍 4 例，排尿功能障碍 3 例。所有患者均顺利完成手术。术后 12 例（85.7%）疼痛明显缓解，视觉模拟评分法（VAS）评分术前为 5.9±1.2，术后 1 天、3 个月及末次随访时分别为 2.9±1.5、2.3±1.3、2.6±1.0，术后各时间点 VAS 评分均较术前明显降低（均 P＜0.01）。术后麻木症状改善 4 例（57.1%），下肢运动障碍 1 例肌力由 4 级恢复至 5 级。排便功能障碍 2 例（50%）和排尿功能障碍 2 例（66.7%）患者术后症状均有不同程度改善。术后磁共振成像显示囊肿填充满意，未见囊肿复发。
脊柱内镜治疗骶管 Tarlov 囊肿具有初步的临床疗效，安全有效。
