PMC3205499_01
In many cases, cysts may appear as discrete T2 hyperintense masses. Sagittal (a) and axial (b) views from the T2-weighted MRI demonstrate the presence of the T2-hyperintense ovoid-shaped perineural cyst from the described clinical case
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F4
MR imaging (MRI) of the lumbosacral spine demonstrated a 1.7 cm x 1.4 cm mass with a homogenously bright T2 signal [Figure 4] and this mass did not demonstrate contrast filling on CT myelogram.
The sacral roof is removed en bloc. Careful dissection will preserve the anatomy of the underlying cyst as shown here. Given the close association of the sacral nerve roots and cauda equina (seen below and alongside the cyst), the cyst wall is closely tested with a nerve probe
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F5
Intra-operative images showing the cyst following removal of the sacral roof as well as replacement of the bone with laminoplasty are shown in [Figures 5 and 6].
Commonly severe bony erosion is found on the undersurface of the sacral roof as shown in (a). The lamina of a sacral roof are repositioned and secured with titanium mini-plates following cyst imbrication, closure, and placement of fibrin glue sealant. The lamina of a sacral roof are repositioned and secured with titanium mini-plates following cyst imbrication, closure, and placement of fibrin glue sealant (b)
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F6
Intra-operative images showing the cyst following removal of the sacral roof as well as replacement of the bone with laminoplasty are shown in [Figures 5 and 6].