Perineural cyst of the spine is a volumetric formation in the lumen of the spinal canal that can squeeze the spinal nerves and cause pain symptoms.
Only one in five cases of diagnosis of this cyst is symptomatic. In most cases, they are found in the lower parts of the spinal column.
Small perineural cysts are present in 7% of the world's population. And they are more common in women than in men.
Perineural cysts are formed due to the extension of the spine nerve root, which later begin to be filled with cerebrospinal fluid( CSF).The reasons for this may be an increase in the pressure of the cerebrospinal fluid, a barrier to the current of the cerebrospinal fluid, a trauma to the spinal cord.
Small cysts are asymptomatic. But as soon as they reach a certain size, their walls begin to squeeze the nerve fibers emerging from the spinal cord. From this moment, neurological disorders begin to appear. These neurological disorders can be both weakly and strongly pronounced.
Symptoms of the perineural cyst of the spine:
- pain during movement;
- pain in the lower back, buttocks, sacrum;
- pain during prolonged sitting on stool;
- muscle weakness;
- headaches, abdominal pain;
- problems with the act of defecation( constipation);
- problems with the bladder;
- lameness associated with muscle pain and weakness;
- paresthesia( tingling, crawling) in the feet and feet.
Often, perineural cysts can clinically simulate other diseases.
At occurrence of the given symptomatology and at suspicion at itself the given pathology, it is necessary to consult the neurosurgeon.
Diagnosis of the perineural cyst of the spine
After revealing the clinical symptoms, go on to the instrumental methods of examination. The leading method in the diagnosis of perineural cysts is magnetic resonance imaging( MRI) of the lower spine. It is not uncommon for MRI to detect more than one cyst. Often, these cysts are diagnosed accidentally during an MRI scan for another pathology.
Treatment of the perineural cyst of the spine
Perineural cysts are treated surgically. After gaining access to the cyst, it is opened and evacuated from there by liquid. Further, it introduces fibrin glue for the adhesion of the cavity of the cyst and prevents the further formation of cysts at this site. This operation can be completed by excising the root of the cyst and removing the thin plate from the vertebra.
These operations are indicated for cysts with a volume greater than 1.5 cm. But this surgical intervention has a number of serious complications, such as loss of cerebrospinal fluid and the emergence of bacterial meningitis. As it is possible the emergence of aseptic postprocedural meningitis.
Some studies have found that the combined use of anti-inflammatory drugs and physiotherapy reduces the severity of symptoms of perineural cysts. Therefore, it is always necessary to consult a competent specialist in this field before choosing a particular treatment method.
