Clinical Analysis of Symptomatic Lumbosacral Intraspinal Extradural Cysts

Object: The authors report a retrospective analysis of treating 18 patients with symptomatic lumbar intraspinal extradural cysts from April 2003 to January 2008. Methods: Patient characteristics including age, sex, symptoms, and neuroimaging studies were reviewed. Surgical procedures, results, and pathological findings were then correlated with preoperative assessment. Results: Patients consisted of 14 men and 4 women with an average age of 68 years (range 41-90 years). The most common symptoms were painful radiculopathy (100%), back pain (83%), and neurogenic claudication (100%). The most commonly affected level was L_ (56%). Fourteen patients were surgically treated for symptomatic lumbosacral intraspinal extradural cyst. Four patients were treated with conservative therapy and experienced spontaneous resolution of their cyst. Conclusions: Lumbar intraspinal cysts can be a cause of lumbar radicular pain and intermittent claudication. Surgical removal of the cyst is a safe and effective treatment for symptomatic patients. However, spontaneous resolution of the cystic lesion can occur in some patients, so meticulous follow-up may play an important role in some cases.