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26 January 2007

Calling all neurologists... Can anyone who is an MD, preferably a neurosurgeon, explain this in plain English?[More:]Current treatment options for symptomatic perineural cysts involve extensive surgery with sacral laminectomy and cyst excision or, more recently, microsurgical cyst fenestration
and imbrication.

Thanks!
Yes, I'm seeing a doctor. Just hoped to understand something I came across on the internet.
posted by Twiggy 26 January | 22:26
Um, my dad is a neurologist. I'll forward your question to him.
posted by pieisexactlythree 26 January | 22:52
What part of "[sacral laminectomy and cyst excision] or [microsurgical cyst fenestration and imbrication]" don't you understand?
posted by mischief 26 January | 22:58
BTW, I work at an architecture firm, so I can tell you that fenestration refers to the placement of windows on a building in that context.
posted by pieisexactlythree 26 January | 23:08
Rough translation, as I'm more at the B.A. level in neurophysiology, and my specialty is in the brain:

Current treatment options for symptomatic perineural cysts

What we can do for you if you have cysts around your neurons that cause you problems (i.e., pressure/pinching on your nerves)

involve extensive surgery with sacral laminectomy

We will operate on your sacrum and remove layers (lamina in Latin is "layer") to relieve the pressure

and cyst excision

We cut out the cysts

or, more recently, microsurgical cyst fenestration and imbrication.

we cut holes in the cysts (I assume) to relieve pressure (like windows, French: fenetre).

Imbrication I'm not sure on, it seems to mean they will arrange the sacral lamina in a tiled fashion. I can see if they have to excise a sizeable cyst, pulling the lamina to cover the area of the excision.
posted by Eideteker 26 January | 23:53
Ah, that sounds like exactly what it is.

im·bri·ca·tion
3. Surgery. overlapping of layers of tissue in the closure of wounds or in the correction of defects.

So they cut out the affected area and then pull the surrounding tissue together to cover the place where they cut. Like pulling curtains shut when the sun comes through a crack between them.

ikkyu2, if he feels like it, can jump in and correct me and refine my answers. Hopefully, I've pretty much answered your question the best I can without drawing a diagram for you.
posted by Eideteker 26 January | 23:58
We want a diagram!!!
posted by mischief 27 January | 01:29
Eide's right, as far as I know.
posted by ikkyu2 27 January | 01:29
Thanks for the information, Eideteker, and the confirmation, ikkyu2.

So, basically, the surgery is to scrape off some of the sacrum bone itself, then remove the cyst or part of it to relieve the pressure that's causing the pain?

I know you guys aren't surgeons, but is this considered major surgery?
posted by Twiggy 27 January | 16:52
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