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

Abstract

BACKGROUND:

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.

• Authors: Wei Jiang, QuanHe Qiu, Jie Hao, XiaoJun Zhang, Wei Shui, ZhenMing Hu
• Journal: PloS one (PLoS One) Vol. 10 Issue 2 Pg. e0118254 ( 2015) ISSN: 1932-6203 [Electronic] United States
• PMID: 25706639 (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