Presentation
Lower back pain.
Patient Data
Evidence of a well-defined tubular shaped macrolobulated cystic lesion at the level of the sacrum and extending to the mid-L5 vertebral body. The lesion measures about 90*20 mm. It shows CSF signal intensity (low signal intensity on T1WIs and hyperintense signal on T2WIs, the lesion leading to morphological changes in the sacral vertebral bodies consistent with posterior scalloping, the findings in favor of a spinal meningeal cyst.
At L5-S1 disc space: Moderate degenerative dehydration, mild to moderate decreased height with evidence of a posterior left paracentral focal disc herniation indenting the ventral theca with no central canal stenosis.
Case Discussion
Spinal meningeal cysts are usually asymptomatic and typically found incidentally at MRI, but if they are large, they may cause mass effect and symptoms relating to compression of local structures, e.g. nerve roots.CSF pulsation can also remodel the surrounding bone