Analysis of the therapeutic efficacy of lumbar cistern drainage combined with pedicled muscle flap using fibrin glue in the treatment of sacral canal cysts

WANG Jihua; XIE Jiaxin; LIU Yuyang; JIANG Haili; YANG Ling; FENG Yaping

Abstract：Objective To explore the therapeutic efficacy of lumbar cistern drainage combined with biologic fibrin glue and muscle flap application in the treatment of sacral meningeal cysts.Methods A retrospective analysis was conducted of data from 82 patients with symptomatic sacral meningeal cysts admitted between January 2018 and June 2023,all of whom underwent lumbar cistern drainage combined with biologic fibrin glue and muscle flap treatment for sacral meningeal cysts.Results All of the 82 patients successfully underwent the surgery and follow-up,with a follow-up period ranging from 6 to 14 months(average 10 months).The Japanese Orthopedics Association(JOA)and Visual Analogue Scale(VAS)were used to evaluate the neurofunctional improvement after the third and sixth months postoperatively.The JOA score increased from 16.09±1.91 preoperatively to 23.09±1.77 postoperatively,showing a statistically significant difference(t=-40.75,P<0.05),whereas the VAS score decreased from 5.52±1.28 preoperatively to 2.22±0.83 postoperatively,with a statistically significant difference(t=31.023,P<0.05).Pain disappearance was observed in 38 cases(46.34%),improvement in 36 cases(43.90%),and no change in 5 cases(6.09%).Sensory disturbances disappeared in 19 cases(23.17%),improved in 26 cases(31.70%),and showed no change in 6 cases(7.32%).Lower limb weakness disappeared in 2 cases(2.44%),improved in 5 cases(6.09%),and showed no change in 2 cases(2.44%).Bowel dysfunction disappeared in 6 cases(7.32%),improved in 15 cases(18.29%),and showed no change in 4 cases(4.88%).Urinary dysfunction disappeared in 6 cases(7.32%),improved in 13 cases,and showed no change in 4 cases(4.88%).Sexual dysfunction showed no disappearance(0.00%),improvement in 2 cases(2.44%),and no change in 3 cases(3.66%).Conclusion Lumbar cistern drainage combined with biologic fibrin glue and muscle flap application is an effective,low recurrence rate,and complication-minimized treatment for sacral meningeal cysts.