Table 1

Summary of the treatment offered to the patient with indications and outcome

No.	Year	Surgical procedure	Indication	Outcome
1	1990	L1-3 laminectomy with exenteration of cyst in the conus medullaris	Recurrent UTI and bladder disturbance (enuresis)	1. Loss of bladder sphincter control
				2. Left-sided foot drop
				3. Bilateral thigh and buttock anaesthesia
				4. Bilateral lower limb weakness
2	1995	Re-exploration of conus medullaris with radical evacuation of cyst	Lower back pain radiating to left hip	Pain free for 4.5 years
3	2000	Reopening of previous surgical incision and further evacuation of cyst	Lower back pain	Nil new
4	2004	Re-exploration of lumbar wound and complete debulking of intramedullary cyst (pseudomeningocoele formation to allow herniation of cyst contents)	Persistent left hip and groin pain	Chemical meningitis and increasing back pain
5	2004	Decompression revision with reopening and evacuation of contents 3 weeks post op	Increasing lower back pain with urinary retention	Persistence of pain but less severe
6	2009	Reopening of wound, further evacuation of cyst	Worsening pain and sensory disturbance affecting right leg also	1. Pain resolved
				2. Persistent neuropathic pain in both legs
				3. Weakness left knee extension
7	2011	L1/L2 re-exploration and debulking of intramedullary epidermoid cyst	Increasing dysmobility due to back pain, lower limb weakness and dysaesthesia leading to poor balance	Lower back pain still present post op but less severe