Abstract
Two operative cases of symptomatic sacral perineural cyst were reported with some review of the pertinent literature. Case 1 was a 41-year-old female who had been suffering from sharp pain in her bilateral S2 territory for 3 months. An MR study revealed bilateral sacral perineural cysts at the S2 level. She was treated by partial resection and closure of the cyst wall following a total laminectomy from L5 to S4. Case 2 was a 38-year-old female with a 4-month history of pain and dullness in the left S2 territory and frequent urination. An MR study disclosed a sacral perineural cyst at the left S2 level. She was treated by bipolar cautery of the cyst wall following the hemilaminectomy of S2, under an electrophysiological monitoring. The symptoms and signs were improved in both cases, though the case 1 required another operation to close the CSF fistula. Comparing surgical results of our cases, the authors concluded that 1) it seems safer to cauterize the cyst wall under the electrophysiological monitoring than to resect it, and 2) a hemilaminectomy around the referred nerve root seems sufficient for treating sacral perineural cysts.
