Sacral cyst managed with cyst-subarachnoid shunt - A technical case report

Study Design: This report describes the cyst-subarachnoid shunt, a novel surgical treatment, for sacral cysts. Objective: To introduce a new surgical technique for sacral cysts. Summary of Background Data: There is no consensus on the appropriate treatment for symptomatic sacral cysts. The hydrostatic and pulsatile forces of cerebrospinal fluid are attributed to the growth of the cyst and their becoming symptomatic. Methods: The clinical and radiologic features of a 41-year-old man with a symptomatic sacral cyst are detailed. A cyst-subarachnoid shunt was set to equalize the cerebrospinal fluid pressure between the cephalad thecal sac and the cyst. Results: Immediately after surgery, the patient had no pain in his left leg and was free of pain at 2 years. Magnetic resonance imaging 1 year after surgery showed a decrease in the size of the cyst. Conclusion: Although this is a preliminary study, a cyst-subarachnoid shunt can be a useful alternative for symptomatic sacral cysts.