Neoplasms

Symptoms and General Pathology

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Nervous System Diseases

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Cysts

Tarlov Cysts

Pathological Conditions, Anatomical

Peripheral Nervous System Diseases

Neuromuscular Diseases

Undergo the modified ostium obstruction surgery due to symptomatic TCs.

An ostium at the end of the site where the nerve root enters the dural sac, from which CSF could flow continuously along the subarachnoid space, was identified An appropriate amount of autologous soft adipose tissue was removed under the skin of the incision or deep in the upper part of the buttock (Iliac spine incision, for less subcutaneous fat patients). It was then trimmed to resemble a gourd or dumbbell, with a relatively small middle section and two relatively large end sections. Trimmed graft was inserted into the neck of the sac and subarachnoid space below the dural sac so that it plugs the ostium inside and outside After filling the graft, Prolene 6-0 was used to continuously suture and close the ostium and dural sac starting from the lower part of the nerve root sheath and the ostium.The residual cyst cavity filled with autologous fat and gelatin sponge

modified ostium obstruction surgery

The pathogenesis of sacral Tarlov cysts (TCs) is still unclear. In this study, histological techniques were used to clarify the anatomical membranous layers of TCs and further explore the pathogenesis of them.Although many approaches have been used to treat TCs, there is no consensus on the optimal treatment. Microsurgery is now increasingly recommended as the preferred treatment with the best long-term outcomes.However, some authors have proposed the opposite view because current microsurgical techniques fail to completely close the ostium between the cyst and subarachnoid space.Consequently, could lead to leakage of cerebrospinal fluid, pseudomeningocele , or a high frequency of cysts recurrence, which are the main reasons for surgical failure and also the biggest scruple when microsurgery is chosen. Herein, we present a new method of cyst separation and ostium closure, and evaluate its clinical reliability and effectiveness for surgical treatment of Tarlov cysts through the prospective study.

1. Part of the intact cyst wall was removed under the microscope and fixed in 10% formalin solution. After dehydration and paraffin embedding, tissue sections (thickness: 6μm) were prepared and dewaxed to water. Sirius red stain drops were stained for 1 hour. The staining liquid on the surface of the slices was removed after a little flushing with water. The slices were dehydrated and transparent, sealed with neutral gum, and the membranous layers of the capsule walls were observed under a microscope.It has been observed in previous surgeries that all cysts were incompressible and remained filled after opening the distal wall of the cyst to release cerebrospinal fluid（CSF). These findings lent support for the proposed valve mechanism as the etiology of the entity becoming symptomatic. In this study, the cyst was observed in the following way: the dural sac was opened to expose the ostium to observe whether the cystic fluid would reverse outflow and shrink the cyst; In this way, the existence of a "one-way valve" can be further verified.
2. Modified microsurgical method is used to treat patients who met the inclusion criteria. To evaluate the surgical effect, we record and statistically compare the patients'outcomes before surgery and at the postoperative follow-up, which include the following: 1) Demographic data: sex, age, height, weight, body mass index (BMI), etc.; 2) clinical manifestations: symptoms and their features, complications, and long-term recovery; 3) Imaging findings: maximum diameter, location, shape, number, intracapsular nerve root condition, and postoperative outcome of TCs. 4) Surgical characteristics: operative process and time, intraoperative blood loss, assistive technologies, etc.; 5) Neurologic assessment using the following tools: The visual analogue scale (VAS), Scoring System for the Clinical Evaluation of Patients with Spinal Processes (hereinafter referred to as SCPS), Oswestry Disability Index (ODI), Japanese Orthopedic Association Scores 29 (JOA), and modified evaluation criteria for the efficacy of lumbar function (MacNab).All patients are required to return for MRI review and neurofunctional assessment at 3 and 12 months postoperatively, followed by annual examinations thereafter.

Study on Pathogenesis and Treatment of Sacral Tarlov Cysts

All IPD that underlie results in a publication

The visual analogue scale (VAS)，Score range: 0-10, with a higher score indicating more severe pain

Scoring System for the Clinical Evaluation of Patients with Spinal Processes (hereinafter referred to as SCPS)，score range：0- 25.The higher the score, the better the spinal cord function state.

Part of the intact cyst wall was stained with Sirius red and its anatomical membranous layers were observed under a microscope.

Southern Medical University, China

Professor

patients with a new treatment of tarlov cysts

patients with traditional treatment of tarlov cysts

patients with tarlov cysts treated by entraped and plasty nerve root

entraped treatment

patients with tarlov cysts treated by plasty nerve root

plasty treatment

liu bin

wu chao

wang zhenyu

xie jinchen

The subject will treat 68 patients with symptomatic sacral canal cysts as the research object, and adopt a randomized controlled research method, respectively, using two methods of reinforcement and reconstruction of the nerve root sleeve, sacroplasty and nerve root sleeve plasty, and observed the operation of the patient Complications, preoperative and postoperative short-term and long-term VAS pain scores, JOA neural function scores, and changes in cyst size on imaging examinations, to evaluate the safety of nerve root sleeve reconstruction and sacroplasty in reducing the safety of postoperative cyst recurrence Sex and effectiveness, so as to further improve the surgical treatment of sacral canal cysts, improve the curative effect, and formulate the operation specifications for the treatment of sacral canal cyst

In this subject, a cohort observation method was used to observe 52 patients with two types of surgical removal of hematoma in the basal ganglia under the guidance of frontal ultrasound through keyhole neuroendoscopy and microsurgery for hematoma removal under the guidance of frontal ultrasound. They were divided into endoscopic surgery group and microsurgery. In the endoscopic surgery group, 26 cases were treated with keyhole neuroendoscopy under the guidance of frontal ultrasound for hematoma removal in the basal ganglia area, and 26 cases in the microsurgery group were treated by craniotomy microsurgery hematoma removal surgery. Observe the removal rate of surgical hematoma in the two groups And the safety of the operation and the GCS score, GOS score and MRI examination of nerve fiber damage and postoperative complications at 1 week, 1 month, and 3 months after the operation. Observe and analyze the improvement of the hematoma clearance rate in the endoscopic surgery group. And whether it has an advantage in terms of efficacy

A Randomized Controlled Study on the Treatment of Sacral Canal Cysts With Sacral Canal Reinforcement

A Randomized Controlled Study of Nerve Root Sleeve Reinforcement and Reconstruction and Sacral Canopy for the Treatment of Sacral Canal Cysts

Beijing Municipal Science & Technology Commission

Peking University Third Hospital

The clinical data of patients with sacral cysts treated with nerve root sleeve reinforcement and reconstruction of the sacral canal cyst were summarized and followed up from 3 to 6 months after the operation to form a case summary and report.

treatment of sacral cysts in patients with sacral cysts by using nerve root sleeve reinforcement

nerve root sleeve reinforcement

bin liu

A retrospective study of the changes in the VAS scores and imaging examinations after the reconstruction and reinforcement of nerve root sleeves and caudal angioplasty for the treatment of sacral cysts from August 2017 to January 2018 was used to evaluate the efficacy of the surgical prescription.

Objective: To clarify the curative effect of nerve root sleeve reconstruction and reinforcement and caudal plasty in the treatment of sacral cysts Design: A retrospective study of the changes in the VAS score and imaging examinations after the reconstruction and reinforcement of nerve root sleeves and sacral canoplasty for the treatment of sacral cysts from August 2017 to January 2018 to evaluate the efficacy of the surgical prescription.

Case Report of Nerve Root Sleeve Reinforcement and Reconstruction and Sacral Canal Plasty for the Treatment of Sacral Canal

The capsule of the cyst is intact and the sacral lamina is not defective

,No other diseases of the nervous system, pelvic floor and important organs Reconstruction of patients with artificial dural nerve root sleeve reinforcement

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Study on Pathogenesis and Treatment of Sacral Tarlov Cysts	NCT05059275	Tarlov Cysts	modified ostium...	-	Southern Medical University, China
A Randomized Controlled Study on the Treatment of Sacral Canal Cysts With Sacral Canal Reinforcement	NCT04465305	Tarlov Cysts	entraped treatm... plasty treatmen...	18 Years - 65 Years	Peking University Third Hospital
Study on Pathogenesis and Treatment of Sacral Tarlov Cysts	NCT05059275	Tarlov Cysts	modified ostium...	-	Southern Medical University, China
Case Report of Nerve Root Sleeve Reinforcement and Reconstruction and Sacral Canal Plasty for the Treatment of Sacral Canal	NCT04960462	Tarlov Cysts	nerve root slee...	-	Peking University Third Hospital
A Randomized Controlled Study on the Treatment of Sacral Canal Cysts With Sacral Canal Reinforcement	NCT04465305	Tarlov Cysts	entraped treatm... plasty treatmen...	18 Years - 65 Years	Peking University Third Hospital
Case Report of Nerve Root Sleeve Reinforcement and Reconstruction and Sacral Canal Plasty for the Treatment of Sacral Canal	NCT04960462	Tarlov Cysts	nerve root slee...	-	Peking University Third Hospital

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