I was recently diagnosed with perineural cysts from T7 to T11 on both sides of my spinal cord. Also have degenerative disc disease at T5 & T6. The Pain Clinic doc says the cysts are not operable and cannot be drained. Too risky. Had my first transforaminal ESI yesterday...not sure how well that worked yet. Everything I find on the internet says these cysts are removed or drained & filled with fibrin glue. If nothing is done, there's a pretty good chance these things could grow and put me in a wheelchair. I'll be 44 on Sunday. So my question is this...what is the specific risk of surgery. I'm not a nurse but worked in healthcare for 15 years. Doc didn't explain...just said too risky because of having to move organs (heart, lungs, etc.) around. I'd like details. Thanks.
Perineural cysts (also called Tarlov cysts) are abnormal fluid-filled sacs located in the sacrum, the base of the spine. Perineural cysts appear to be dilated or ballooned areas of the sheaths that cover nerve roots exiting from the sacral area of the spine.
They can also occur anywhere along the spine.
conditions that can increase the flow of cerebrospinal fluid may cause perineural cysts to expand in size, creating symptoms. Such conditions include traumatic injury, shock, or certain forms of exertion (such as heavy lifting) or exercise.
steroid injections can provide short-term pain relief. Pain may also be temporarily controlled by injecting the cysts with fibrin glue (a substance produced from blood chemicals involved in the clotting mechanism). Using diet or dietary supplements to decrease the body's alkalinity may prevent perineural cysts from filling with more fluid. Medications used to treat chronic nerve-related pain (such as anticonvulsants and antidepressants) may be helpful.
When pain is intractable despite a variety of interventions, or when weakness or other neurological symptoms become severe, surgery to remove the cysts may be necessary. This is the only permanent treatment for perineural cysts; once removed, they very rarely recur.
The risk - benefit ratio is more towards the risk. The site of operation is deep seated, and the surgeon has to manipulate a lot of organs to reach it. The situation (T7-11) has a lot to do with the risk. As such, there is not 'specific' risk withi this procedure. But it carries the risks of a major surgery.
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