Evaluation of the Usefulness and Therapeutic Effect of Percutaneous Endoscopic Perineural Cyst Puncture

Perineural cysts are often found incidentally in the sacral region of the spine. Most cases are asymptomatic or mildly symptomatic and are treated conservatively. Few cases are symptomatic and require surgical intervention. Although several surgical treatments for perineural cysts have been described, including cyst fenestration, wrapping, fibrin glue injection, and cyst-peritoneal shunt, there is no consensus on the operating procedures with respect to their success or recurrence rates. The presence of a check-valve mechanism indicates the growth of perineural cysts. A “delayed filling” appearance via computed tomographic myelography was considered to show the mechanism of cyst formation ; thus, it may be a prognostic factor of effective post-treatment outcomes.