Sacral canal cysts are common, and most of them are asymptomatic. Asymptomatic people generally do not need treatment, so they can be observed first. For those with symptoms, active surgical treatment should be performed on the premise of excluding disc herniation, spinal canal stenosis or sacral tumor.

Surgical indication

Generally speaking, surgical treatment is feasible in the following situations: low back and leg pain or intermittent claudication is ineffective, affecting normal life or work; Lumbago and leg pain with decreased muscle strength and hypoesthesia of lower limbs; Perineal pain or hypoesthesia, defecation or sexual dysfunction.

Surgical therapy

The operation should be performed under a microscope, and the cyst wall should be trimmed and shaped. Sharp excision of the cyst wall with micro scissors should not be a blunt dissection, so as not to damage nerve roots, nor should it be forcibly removed completely. Cerebrospinal fluid leakage should be found, closed by vascular anastomosis (type IA), or nerve root sleeve remodeling (type II).

Matters needing attention

After operation, the patient should take a prone position, with his head as low as possible and his hips as high as possible, and compress the wound with sandbags. 1 week, wear waist after operation, and do functional exercise after 3 weeks.

At present, the most reasonable and reliable treatment is mainly microsurgery. It is not recommended to adopt "minimally invasive" methods such as cyst aspiration and drug injection, which can not eliminate the occupying effect of cyst and reduce the influence of cerebrospinal fluid on the tissues around cyst.