A novel microsurgical method for the treatment of spinal nerve root cysts.

Introduction: The treatment of spinal nerve root cysts is not uniform. In the past decades, microsurgical resection to preserve nervous tissue has been reported. We report on our microsurgical method and present the clinical results in relation to surgical outcome.

Material And Methods: Retrospective review of a consecutive series of patients who underwent surgical cyst closure from 2006 to 2010.

Results: Twelve patients, all female, with a total of 23 cysts underwent surgery for 20 symptomatic cysts. The mean age was 45 (range 13-75) years. Following treatment with this procedure, 95% of the cysts were closed and 5% had notably diminished at post-operative magnetic resonance imaging. Clinical improvement was seen in 67% of the patients; one improved temporarily, two remained unchanged and one had worsened at the last follow-up. The mean post-operative follow-up period was 11 (range 3-19) months. Clinical outcome was associated with none of the pre-operative parameters, i.e. pain-provoking postural position, cyst size, number of treated cysts, educational level or pre-operative sick leave.

Conclusion: We find that our surgical technique is suit-able for closure of spinal nerve root cysts; however, the clinical outcome after surgery was sub-optimal according to preoperative clinical judgement. Consequently, we have established a dedicated outpatient clinic that performs extensive pre-operative assessment and investigation of patients with symptomatic spinal nerve root cysts. We hereby hope to improve surgical outcome in the future.