• Four cases of meningeal cysts in the sacral region are reported in detail, supplementing a series previously reported. Low back pain, unexplained by usual diagnostic procedures and resistant to ordinary treatment, led to the use of delayed myelography with iophendylate, which showed the existence of diverticula of the root sheaths of various sacral nerves.
The x-ray evidence was confirmed at operation. Laminectomy revealed not only the cysts filled with contrast medium but also extensive cavitations in the bone. Opening the cysts and resecting the affected nerve roots was followed by great improvement in the patient's condition in each case.
These cases show that cyst-like diverticula of the nerve sheaths can develop in adult life, that they can cause local pressure atrophy in bone, and that they are amenable to treatment.
Strully KJ. MENINGEAL DIVERTICULA OF SACRAL NERVE ROOTS (PERINEURIAL CYSTS). JAMA. 1956;161(12):1147–1152. doi:10.1001/jama.1956.02970120029009
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