Surgical treatment of giant sacral terminal filar cysts: a case report and review of the literature.

Abstract

Background: Sacral terminal filar cysts are a rare and distinctive type of sacral canal cyst, which are anatomically characterized by the presence of filum terminale within the cyst rather than nerve roots. Given their rarity and therapeutic challenges, the presentation of this case report aims to share a novel and effective treatment approach, providing valuable reference for clinicians.

Case presentation: A 39-year-old Chinese woman patient presented to our hospital with symptoms including lumbosacral pain, anal distension, increased frequency of urination, and incomplete urination. Magnetic resonance imaging scans revealed a sacral canal cyst compressing the adjacent sacral nerve roots. We performed minimally invasive surgery, guided by magnetic resonance imaging and computed tomography scans, to precisely remove the cyst. Six months postoperatively, a follow-up visit revealed normalized bowel and bladder functions, indicating a successful outcome.

Conclusion: The present study proposes an effective treatment strategy for sacral terminal filar cysts. Initially, magnetic resonance imaging scan results were employed to ascertain the location of the leak and to identify the corresponding cross-section of the leak in the computed tomography scan results. Subsequently, three-dimensional reconstruction of the computed tomography scan results was conducted to determine the extent of a visualized surgical incision. Ultimately, minimally invasive surgical treatment was performed.