Microsurgical treatment of spinal epidermoid and dermoid cysts in the lumbosacral region

The aim of this study was to evaluate the characteristics and surgical outcome of spinal epidermoid and dermoid cysts in the lumbosacral spine. We reviewed 26 patients with spinal epidermoid and dermoid cysts (15 epidermoid and 11 dermoid) treated between October 2000 and December 2010. The latter 15 patients of this series underwent neurophysiological monitoring during surgery. Gross total resection of the tumour was achieved in 46.2% of patients, and 53.8% underwent subtotal resection. In 14 patients, the tumour capsule adhered so tightly to the neural structures that a section of the capsule remained in situ. After surgery, the Japanese Orthopaedic Association score improved in 80.8% of patients, remained stable in 15.4%, and declined in 3.8%. The average follow-up period was 53 months. Three patients developed recurrence of the tumour and 20 patients resumed a normal working life. Microsurgical techniques and intraoperative neurophysiological monitoring are practical and reliable methods for radical removal of spinal epidermoid and dermoid cysts that involve the conus medullaris and cauda equina.