Diagnosis and management of sacral Tarlov cysts

2003 ◽  
Vol 15 (2) ◽  
pp. 1-7 ◽  
Author(s):  
Frank L. Acosta ◽  
Alfredo Quinones-Hinojosa ◽  
Meic H. Schmidt ◽  
Philip R. Weinstein
Keyword(s):  
Medical Literature ◽  
Clinical Presentation ◽  
Treatment Strategies ◽  
Spinal Nerve ◽  
Nerve Roots ◽  
Tarlov Cyst ◽  
Root Sheath ◽  
Spinal Subarachnoid Space ◽  
Tarlov Cysts ◽  
Flap Repair

Perineurial (Tarlov) cysts are meningeal dilations of the posterior spinal nerve root sheath that most often affect sacral roots and can cause a progressive painful radiculopathy. Tarlov cysts are most commonly diagnosed by lumbosacral magnetic resonance imaging and can often be demonstrated by computerized tomography myelography to communicate with the spinal subarachnoid space. The cyst can enlarge via a net inflow of cerebrospinal fluid, eventually causing symptoms by distorting, compressing, or stretching adjacent nerve roots. It is generally agreed that asymptomatic Tarlov cysts do not require treatment. When symptomatic, the potential surgery-related benefit and the specific surgical intervention remain controversial. The authors describe the clinical presentation, treatment, and results of surgical cyst fenestration, partial cyst wall resection, and myofascial flap repair and closure in a case of a symptomatic sacral Tarlov cyst. They review the medical literature, describe various theories on the origin and pathogenesis of Tarlov cysts, and assess alternative treatment strategies.

scholarly journals Depressive symptomatology in a female patient with Tarlov cyst

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984469
Author(s):  
Konstantinos Kontoangelos ◽  
Marina Economou ◽  
Vasiliki Katsi ◽  
Charalambos Papageorgiou
Keyword(s):  
Depressive Symptomatology ◽  
Sudden Onset ◽  
Spinal Nerve ◽  
Magnetic Resonance Imaging Scan ◽  
Cystic Dilatation ◽  
Nerve Roots ◽  
Tarlov Cyst ◽  
Tarlov Cysts ◽  
Lumbar Area ◽  
First Time

Introduction: The spinal perineurial cyst is a rare anomaly of the nervous system. It is also known as Tarlov cyst, since it was described for the first time by Isadore M. Tarlov. The pathology is defined as a cystic dilatation between the perineurium and endoneurium of spinal nerve roots, located at the level of the spinal ganglion and filled with cerebrospinal fluid but without communication with the perineurial subarachnoid space. Case report: We present the case of a 56-year-old female who reported sudden onset of symptoms of a depressive symptomatology accompanied with acute pain in the lumbar area. Lumbosacral magnetic resonance imaging scan revealed Tarlov cysts. Discussion: Radiological investigations in patients with depressive symptomatology may be substantial.

scholarly journals A Case Report: Symptomatic Sacral Tarlov Cyst in a Male of 24 Years

2017 ◽  
Vol 5 (2) ◽  
pp. 99-103
Author(s):  
Quadrat A Eahsan Ullah ◽  
Muhammad Awlad Hussain ◽  
Abu Sayed ◽  
Mohammad Abdul Quader
Keyword(s):  
Cyst Wall ◽  
Functional Results ◽  
Spinal Nerve ◽  
Pathological Examination ◽  
Radiographic Examination ◽  
Benign Condition ◽  
Tarlov Cyst ◽  
Spinal Subarachnoid Space ◽  
Tarlov Cysts ◽  
Magnetic Resonance Imaging Mri

Perineural (Tarlov) cyst, a rare but benign condition, is meningeal dilatations of the posterior spinal nerve root sheath that most often affects sacral roots and can cause a progressive painful radiculopathy. Tarlov cysts are most commonly diagnosed by lumbosacral magnetic resonance imaging (MRI) and can often be demonstrated by computerized tomography (CT) to communicate with the spinal subarachnoid space. The cyst can enlarge via a net inflow of cerebrospinal fluid, eventually causing symptoms by distorting, compressing, or stretching adjacent nerve roots. It is generally agreed that asymptomatic Tarlov cysts do not require treatment. When symptomatic, the potential surgery-related benefit and the specific surgical intervention remain controversial. A 24 years old male presented with a history of trauma and pain in his low back with dull headache for six months. Physical and radiographic examination was consistent with tarlov cyst. Microsurgical excision with plication of the cyst wall was performed. Histo-pathological examination confirmed the diagnosis of Tarlov cyst. Excellent clinical and functional results were obtained with no recurrence after 6 months of follow-up. Tarlov cyst in a male of age 24 is a rare entity and decision making for management poses difficulties. Our experience with microsurgical excision with plication of the cyst wall was quite satisfactory with excellent clinical result, and we recommend this as one of the satisfactory modalities of treatment of Tarlov cyst in adult.Delta Med Col J. Jul 2017 5(2): 99-103

Tarlov Cyst Causing Sacral Insufficiency Fracture

2017 ◽  
Vol 13 (3) ◽  
pp. E4-E7 ◽  
Author(s):  
Ross C. Puffer ◽  
Marcus J. Gates ◽  
William Copeland ◽  
William E. Krauss ◽  
Jeremy Fogelson
Keyword(s):  
Bone Erosion ◽  
Insufficiency Fracture ◽  
Bowel Dysfunction ◽  
Insufficiency Fractures ◽  
Large Area ◽  
Nerve Roots ◽  
Posterior Aspect ◽  
Sacral Insufficiency Fracture ◽  
Tarlov Cyst ◽  
Tarlov Cysts

Abstract BACKGROUND AND IMPORTANCE: Tarlov cysts, also known as perineural cysts, have been described as meningeal dilations of the spinal nerve root sheath between the peri- and endoneurium at the dorsal root ganglion. Most often they are found in the sacrum involving the nerve roots. Normally asymptomatic, they have been reported to present with radiculopathy, paresthesias, and even urinary or bowel dysfunction. Sacral insufficiency has not been a well-documented presentation. CLINICAL PRESENTATION: The patient is a 38-year-old female who started to develop left low back pain and buttock pain that rapidly progressed into severe pain with some radiation down the posterior aspect of her left leg. There was no recent history of spine or pelvic trauma. These symptoms prompted her initial emergency department evaluation, and imaging demonstrated a large Tarlov cyst with an associated sacral insufficiency fracture. She was noted to have a normal neurological examination notable only for an antalgic gait. She was taken to surgery via a posterior approach and the cyst was identified eccentric to the left. The cyst was fenestrated and the nerve roots identified. Given her large area of bone erosion and insufficiency fractures, fixation of the sacroiliac joints was deemed necessary. Fusion was extended to the L5 vertebral body to buttress the fixation. She tolerated the procedure well and was discharged from the hospital on postoperative day 3. CONCLUSION: Tarlov cysts of the sacrum can lead to significant bone erosion and subsequent insufficiency fractures, requiring fenestration and in some cases, complex sacropelvic fixation.

scholarly journals Glue That Pain: A Case Report and Review of Literature

2021 ◽  
Vol 24 (4) ◽  
pp. 387-392
Author(s):  
Umar Farooq ◽  
Asad Abbas ◽  
Asfand Baig Mirza ◽  
Faiza Nazir ◽  
Hiten Mehta ◽  
...  
Keyword(s):  
Symptomatic Relief ◽  
Needle Aspiration ◽  
Review Of Literature ◽  
First Line ◽  
Ct Guided ◽  
Tarlov Cyst ◽  
Root Sheath ◽  
Tarlov Cysts ◽  
Surgical Options ◽  
Csf Diversion

Tarlov cysts are cystic lesions of the nerve root sheath in the lower spine. With a reported incidence ranging from 1 to 5%, these lesions are fairly rare, benign and often asymptomatic. When they cause neural compression they may become symptomatic with sensory, motor, bowel/bladder and sexual dysfunction. The treatment of symptomatic Tarlov cysts is a controversial issue, ranging from conservative management and local steroid injections to a bewildering assortment of surgical options including CSF diversion procedures and advance microsurgical approaches with various ways of cyst manipulation. All these surgical modalities carry a high risk of serious complications, recurrence with need of a redo operation and a very variable rate of symptomatic relief ranging from 38 – 100 % in different series. Developing from the CT guided needle aspiration of the cyst which suffered disappointment in the form of re accumulation and heralded by earlier reports of aseptic meningitis, CT guided aspiration and subsequent filling of the cyst with fibrin glue has now emerged as a safe, highly effective and first line of treatment for symptomatic Tarlov cyst.

Spinal Perineural Cysts among European Patients

2021 ◽  
Author(s):  
Piotr Kozłowski ◽  
Paweł Kalinowski ◽  
Magdalena Kozłowska ◽  
Małgorzata Jankiewicz ◽  
Agnieszka Budny ◽  
...  
Keyword(s):  
Spinal Nerve ◽  
Spinal Nerve Roots ◽  
Resonance Imaging ◽  
Nerve Roots ◽  
Tarlov Cyst ◽  
Sacral Region ◽  
Single Cyst ◽  
Degenerative Disk Disease ◽  
Spinal Mri ◽  
Magnetic Resonance Imaging Mri

Abstract Background A perineural (Tarlov) cyst is a fluid-filled lesion occurring between the perineurium and the endoneurium of spinal nerve roots. The aim of the study was to evaluate the prevalence and morphology of perineural cysts, detected incidentally in patients with symptomatic degenerative disk disease. Materials/methods The study was based on the retrospective data gathered during magnetic resonance imaging (MRI) examinations. Results and Conclusions Out of 3,128 spinal MRI examinations, perineural cysts were detected in 286 patients (9%). The cysts were most commonly observed in the sacral region, followed by thoracic, cervical, and lumbar regions. Cysts were more common in women than in men and the average age of patients was 54.8 years. In the majority, a single cyst was found. The average longest dimension of the lesion was 11.72 mm.

scholarly journals EOSINOPHILIC ESOPHAGITIS AND ACHALASIA: TWO DISTINCT NOSOLOGIC ENTITIES OR A POSSIBLE ETIOPATHOGENIC ASSOCIATION?

2021 ◽  
Author(s):  
Dimitrios Schizas ◽  
Athanasios Syllaios ◽  
Michail Vailas ◽  
Maria Sotiropoulou ◽  
Tania Triantafyllou ◽  
...  
Keyword(s):  
Eosinophilic Esophagitis ◽  
Esophageal Motility ◽  
Medical Literature ◽  
Clinical Presentation ◽  
Treatment Algorithm ◽  
Treatment Strategies ◽  
Current Treatment ◽  
Scientific Data ◽  
Esophageal Diseases ◽  
Diagnostic Modalities

Background: Despite the fact that researchers have made significant progress in elucidating pathophysiology of esophageal diseases, the understanding of esophageal motility alterations in patients with eosinophilic esophagitis is in its infancy and current published medical literature remains rather scarce on this topic. A growing body of scientific data regarding associations between esophageal motor disorders such as achalasia and eosinophilic esophagitis exists nowadays. Summary: It seems that association of eosinophilic esophagitis and achalasia does not constitute a cause and effect relationship, as it is not clear whether esophageal motility abnormalities are the result of eosinophilic esophagitis or vice versa. As such, there is no universally accepted treatment algorithm for patients presenting with both of these entities. Key messages: The aim of this article is to review the existing data on achalasia-like motility disorders in patients with eosinophilic esophagitis, highlighting possible association between these two esophageal disorders. Moreover, we seek to describe the clinical presentation in such cases, diagnostic modalities to be used and current treatment strategies in patients suspected to suffer from both disorders.

scholarly journals A Novel Collaborative Protocol for Successful Management of Penile Pain Mediated by Radiculitis of Sacral Spinal Nerve Roots From Tarlov Cysts

2017 ◽  
Vol 5 (3) ◽  
pp. e203-e211 ◽  
Author(s):  
Irwin Goldstein ◽  
Barry R. Komisaruk ◽  
Rachel S. Rubin ◽  
Sue W. Goldstein ◽  
Stacy Elliott ◽  
...  
Keyword(s):  
Spinal Nerve ◽  
Spinal Nerve Roots ◽  
Successful Management ◽  
Nerve Roots ◽  
Penile Pain ◽  
Tarlov Cysts

Enlarged spinal nerve roots in RASopathies: Report of two cases

2021 ◽  
Vol 64 (4) ◽  
pp. 104187
Author(s):  
Leoni Chiara ◽  
Tedesco Marta ◽  
Talloa Dario ◽  
Verdolotti Tommaso ◽  
Onesimo Roberta ◽  
...  
Keyword(s):  
Spinal Nerve ◽  
Spinal Nerve Roots ◽  
Nerve Roots

Lumbosacral intersegmental epispinal axons and ectopic ventral nerve rootlets

1987 ◽  
Vol 67 (2) ◽  
pp. 269-277 ◽  
Author(s):  
Wesley W. Parke ◽  
Ryo Watanabe
Keyword(s):  
Nerve Root ◽  
Sensory Nerve ◽  
Conus Medullaris ◽  
Spinal Nerve ◽  
Nerve Fibers ◽  
Ventral Horn ◽  
Spinal Nerve Roots ◽  
Nerve Roots ◽  
Content Type ◽  
Almost All

✓ An epispinal system of motor axons virtually covers the ventral and lateral funiculi of the human conus medullaris between the L-2 and S-2 levels. These nerve fibers apparently arise from motor cells of the ventral horn nuclei and join spinal nerve roots caudal to their level of origin. In all observed spinal cords, many of these axons converged at the cord surface and formed an irregular group of ectopic rootlets that could be visually traced to join conventional spinal nerve roots at one to several segments inferior to their original segmental level; occasional rootlets joined a dorsal nerve root. As almost all previous reports of nerve root interconnections involved only the dorsal roots and have been cited to explain a lack of an absolute segmental sensory nerve distribution, it is believed that these intersegmental motor fibers may similarly explain a more diffuse efferent distribution than has previously been suspected.

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