Tarlov Cyst

(Perineural Cyst; Sacral Nerve Root Cyst)

Definition

Tarlov cysts are abnormal sacs of spinal fluid that usually form at the lower end of the spine, which is called the sacrum. Tarlov cysts contain spinal nerve fibers within the cyst wall.
Sacrum
si55550398 105433 1 sacrum
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Causes

The cause of a Tarlov cyst is unknown but may be related to:
  • Trauma to the spine
  • Increase in cerebrospinal fluid pressure
  • Blockage of cerebrospinal fluid

Risk Factors

Although gender may not be a risk factor, Tarlov cysts have more often been found in women than men. Tarlov cysts may be linked to connective tissue disorders such as systemic lupus erythematosus and Marfan syndrome .

Symptoms

Most of the time, Tarlov cysts do not cause symptoms. When symptoms do occur, they may include:
  • Bladder or bowel dysfunction
  • Sexual dysfunction
  • Nerve pain
  • Pain in the lower back, buttocks, legs and feet, vagina, rectum, or abdomen
  • Pain when coughing or sneezing
  • Weakness, cramping, or numbness in the buttocks, legs, and feet
  • Swelling, soreness, or tenderness around the lower end of the spine
  • Abnormal sensations in the legs and feet, or less commonly in the arms and hands
  • Pain when sitting or standing
  • Headaches
  • Pulling and burning feeling in the tailbone
  • Loss of sensation on the skin
  • Loss of reflexes
If you have a Tarlov cyst, the following may cause it to become painful or cause other symptoms:

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. Depending on your symptoms, you may need to see a specialist, such as a neurosurgeon.Images may be taken of your bodily structures. This can be done with:

Treatment

If you are experiencing symptoms, talk with your doctor about the best treatment plan for you. Options may include:

Medications

To relieve inflammation and/or pain:
  • Over-the-counter or prescription pain relievers, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Topical pain relievers that are applied to the skin
  • Corticosteroid or other medicated injections

Other Treatments

Other treatments may include:
  • Aspiration of the cyst plus fibrin glue injection—a needle is used to drain the cyst and then a special glue is injected into the cyst to try to prevent it from filling again
  • Transcutaneous electrical nerve stimulation (TENS)—electrical impulses delivered through the skin
  • Surgery may be done for severe or worsening symptoms, bowel or bladder dysfunction, or if there is damage to the affected area

Prevention

There are no current guidelines to prevent a Tarlov cyst.

RESOURCES

National Institute of Neurological Disorders and Stroke
http://www.ninds.nih.gov

Tarlov Cyst Disease Foundation
http://www.tarlovcystfoundation.org

CANADIAN RESOURCES

Health Link BC
http://www.healthlinkbc.ca

My Health Alberta
https://myhealth.alberta.ca

References

National Institute of Neurological Disorders and Stroke. Tarlov cyst information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/tarlov%5Fcysts/tarlov%5Fcysts.htm. Updated June 14, 2012. Accessed November 25, 2013.

Therapeutic percutaneous image-guided aspiration of spinal cysts. National Institute for Health and Clinical Excellence website. Available at: http://www.nice.org.uk/guidance/IPG223. Updated 2007. Accessed November 25, 2013.

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