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Percutaneous fibrin gel injection under C-arm fluoroscopy guidance: a new minimally invasive choice for symptomatic sacral perineural cysts.

AbstractBACKGROUND:
Symptomatic sacral perineural cysts are a common cause of chronic pain. Surgery is one choice for symptom relief but has a high risk of cyst recurrence and complications. As a simple and safe method to manage symptomatic sacral perineural cysts, C-arm fluoroscopy-guided fibrin gel injection may represent a new minimally invasive alternative. To evaluate the efficacy of this new method, we conducted a retrospective study of 42 patients.
METHODS AND FINDINGS:
From June 2009 to August 2012, a total of 42 patients with symptomatic sacral perineural cysts underwent C-arm fluoroscopy-guided percutaneous fibrin gel injection therapy. Patient outcomes in terms of improvements in pain and neurologic function were evaluated during a follow-up period of 13-39 months. The preoperative and postoperative pain severity were assessed according to a 10-cm visual analog pain scale, and imaging changes were evaluated by magnetic resonance imaging. We also assessed postoperative complications. Most patients experienced benefit from the procedure: twenty-five patients (59.5%) reported excellent recovery, eleven (26.2%) reported good recovery, three (7.1%) reported fair recovery, and three (7.1%) reported poor recovery. The overall effectiveness rate (excellent and good recoveries) was 85.7%. No serious postoperative complications were observed.
CONCLUSION:
Percutaneous fibrin gel injection under C-arm fluoroscopy guidance could be a simple, safe and effective treatment option for symptomatic sacral perineural cysts.
AuthorsWei Jiang, QuanHe Qiu, Jie Hao, XiaoJun Zhang, Wei Shui, ZhenMing Hu
JournalPloS one (PLoS One) Vol. 10 Issue 2 Pg. e0118254 ( 2015) ISSN: 1932-6203 [Electronic] United States
PMID25706639 (Publication Type: Journal Article)
Chemical References
  • Fibrin
Topics
  • Adult
  • Female
  • Fibrin (administration & dosage)
  • Fluoroscopy (methods)
  • Humans
  • Injections (methods)
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local (prevention & control)
  • Retrospective Studies
  • Tarlov Cysts (therapy)
  • Young Adult

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