G96.191 Perineural cyst

ICD10CM code

#### Name of the Condition
- **Perineural cyst**
- Also known as Tarlov cyst or sacral nerve root cyst.

#### Summary
Perineural cysts are fluid-filled sacs that form on the nerve roots, often in the lower spine or sacral region. While many people with perineural cysts are asymptomatic, others may experience pain or neurological issues.

#### Causes
The exact cause of perineural cysts is not well understood. They may result from blockage of cerebrospinal fluid or trauma to the sacral area. Some experts also suggest a genetic component.

#### Risk Factors
- Genetic predisposition.
- History of trauma to the lower back or sacral area.
- Conditions that increase cerebrospinal fluid pressure.

#### Symptoms
- Lower back pain or sacral pain.
- Sciatica or radicular pain in the legs.
- Weakness or bladder dysfunction.
- Symptoms often worsen with standing or walking.

#### Diagnosis
- MRI or CT scan to visualize the cysts.
- Neurological examination to assess nerve function.
- Occasionally, a myelogram may be used.

#### Treatment Options
- **Conservative treatment**: Pain management with medications like NSAIDs; physical therapy to support mobility and strength.
- **Invasive procedures**: Aspiration of cyst fluid or surgical treatment, potentially providing longer-term relief for persistent cases.
- **Surgical options**: If severe, surgical resection or fenestration of the cyst.

#### Prognosis and Follow-Up
- Many individuals with perineural cysts experience few or no symptoms.
- For those requiring treatment, the prognosis is generally good, although symptoms may recur.
- Regular follow-ups can help manage and monitor symptoms effectively.

#### Complications
- If untreated, may lead to chronic pain or permanent neurological damage.
- Surgical intervention carries risks such as infection or nerve damage.

#### Lifestyle & Prevention
- Maintaining a healthy weight and strengthening core muscles to reduce pressure on the lower spine.
- Preventive measures are unclear due to unknown specific causes.

#### When to Seek Professional Help
- Persistent back or leg pain.
- Incontinence or significant changes in bowel or bladder control.
- Weakness or numbness in the legs.

#### Additional Resources
- National Institute of Neurological Disorders and Stroke (NINDS).
- Tarlov Cyst Disease Foundation for patient support.

#### Tips for Medical Coders
- Ensure proper documentation of symptoms and diagnostic tests to support the use of ICD code G96.191.
- Double-check the regional location and nature of the cyst, as similar codes may exist for different types of cysts.

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