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Protocol for Evaluation and Management of Sacral Cysts

The following is an overview of what will happen once you have contacted us.
  1. First Contact or Referral
  2. Records Arrive with Imaging Studies.
  3. Dr. Long will review first and may send images to Dr. Kathuria (Neuroradiologist) who will also assess the cyst(s) and report to Dr. Long.  This process may take several weeks because of the large volume of patients. An Outpatient Appointment with Dr. Long will be made if appropriate.  Educational material will be sent to you.  Be sure to bring it with appropriate questions prepared.  If you live a significant distance from Baltimore, request a telephone appointment with Dr. Long first to explain your complaints.
  4. The Outpatient Visit.   You will be seen by Dr. Long.  Sometimes additional studies are recommended.  It may be possible to plan treatment of the cyst as the next step.  A plan will be made on this visit for diagnosis and/or treatment if indicated.
  5. If Aspiration/Injection is chosen, you will be given a date by mail or telephone later.  Be sure to ask all questions about the procedure while in the clinic.  It is reasonable to have one telephone appointment with Dr. Long after the clinic visit for clarification of unanswered questions.  Call Patti, 410-828-7513, to set up an appointment.  You will be given a final explanation just before the procedure by the Neuroradiologist and asked to sign a consent before the aspiration is done by Neuroradiology staff. Dr. Long usually can attend the aspiration, but cannot always be present. Dr. Sudir Kathuria or one of his team will do the procedure.  They will have additional information for you.  Please follow their instructions immediately after your aspiration.
  6. If surgery is chosen you will be referred to a potential surgeon.
  7. If no treatment is planned an MRI to reevaluate the cyst in 1-2 years and then beyond is usually recommended because the untreated history of these cysts is unknown.
  8. Follow Up for Aspiration is at 6 weeks by telephone.  MRI is repeated at 3 months.
  9. Should any complication or unexpected events occur after a procedure call the office for assistance (410-828-7513).  In an emergency you can call 911, your personal physician, or go to the closest emergency room.
  10. We will provide short term medication (usually 24-48 hours) for post procedure (aspiration) pain.  If you are in pain management your physician should continue with your usual program for long term care.  He/She can call Dr. Long with any questions.  Dr. Long’s office does not provide long term pain management.  Post surgery medication is provided for two weeks.  Then you can return to your personal or pain management physician.  (See post procedure instructions)
  11. The aspiration procedure requires limiting activity for 48 hours only.  It will not change any existing disability.  You should continue to have all disability forms complete by whoever does them now.  (See post procedure instructions)