MRI scan showing sacral paraneural cyst compressing the sacral nerve root, with annotations highlighting the cyst, nerve, and bone thinning.

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MRI SACRAL PARANEURAL CYSTS AND NERVE COMPRESSION

FROM TODAY'S REPORTING

SACRAL PARANEURAL CYSTS & NERVE COMPRESSION


Compression of a nerve root from a sacral paraneural cyst can be symptomatic. If you deal in pain management, you need to be able to diagnose these and their effect on adjacent nerve roots as they can be symptomatic with nerve compression symptoms and signs.

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MRI PARANEURAL CYSTS & NERVE COMPRESSION

The image demonstrates a sacral cyst (Blue arrow) with the sacral nerve (Pink arrow) displaced and compressed at its margin. Note the benign bone thinning of the sacrum on the right (Orange arrows) compared to normal on the left.
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Key points to consider when evaluating sacral paraneural cysts on MRI:

    • Para neural cysts are extra dural and DON’T have a spinal nerve within them. This is the key finding that differentiates them from Perineural or Tarlov cysts which have a nerve within them or in their wall.

    • Arachnoid herniates through a defect in the dura, and CSF accumulates within it.

    • Sacral cysts are more commonly para neural than perineural.

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Read article: “Electromyography and A Review of the Literature Provide Insights into the Role of Sacral Perineural Cysts in Unexplained Chronic Pelvic, Perineal and Leg Pain Syndromes” From International Journal of Physical Medicine & Rehabilitation, Read HERE

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TEST YOURSELF ON SOME COMMON & FREQUENTLY ASKED QUESTIONS

Perineural cysts also called Tarlov Cysts contain nerve fibers within them or in their walls, while paraneural cysts do not.
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Smooth well defined bone thinning indicates chronic pressure from the cyst and is usually a sign of a lesion being longstanding and benign.
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We look at all of these topics in more detail in our Guided SPINE & SIJ Imaging Mini Fellowships.

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