Wrapping a man-made dura around reconstructed nerve sleeve avoid residue or recurrence of sacral Tolav cysts

Abstract

Objective: To evaluate the therapy effect on patients with sacral extradural meningeal cysts with nerve root fibers by wrapping a man-made dura around reconstructed nerve sleeve. Patients and methods: In order to avoid the cysts residue and recurrence postoperative, wrapping a man-made dura around reconstructed nerve sleeve, a new operating method, was performed in 24 patients with 42 cysts. After the nerve sleeve being reconstructed, wrapping and suturing a man-made dura around the nerve sleeve was performed. The Improved Japanese Orthopedic Association (IJOA) scoring system was used to evaluate preoperative and postoperative neurological function. Results: Among 24 patients, 14 were females, and 10 males. Three-month after open surgery, no cyst residue or recurrence was grasped in any patient. The mean IJOA score was 18.8 ± 1.32 preoperatively and 19.6 ± 0.65 postoperatively, which was a significant difference between the preoperative and postoperative scores (t = −3.82, P = 0.001). These results indicate a significant improvement in neurological function after surgery. Conclusion: Based on reconstruction the nerve sleeve, wrapping with man-made dura and forming double nerve sleeve was safety and effective operating method for treatment the sacral extradural meningeal cysts with nerve root fibers. Keywords: Sacral canal, Spinal meningeal cysts, Nerve root fibers, Reconstructed nerve root sheath, Wrapping nerve sleeve, Residue, Recurrence, Clinical outcomes