• 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 (sacrum). What distinguishes Tarlov cysts is the presence of spinal nerve fibers within the cyst wall.
    Sacrum
    si55550398 105433 1 sacrum
    Copyright © Nucleus Medical Media, Inc.

    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
    Research has shown that the condition may be linked to connective tissue disorders (eg, lupus , Marfan syndrome ). However, researchers are still studying this.
    Once you have a Tarlov cyst, the following may cause it to become painful or cause other symptoms:

    Risk Factors

    Although gender may not be a risk factor, Tarlov cysts have more often been found in women than men.

    Symptoms

    Most of the time Tarlov cysts do not cause symptoms. Cysts may cause pain and other signs of nerve irritation, such as weakness, numbness, burning, and tingling. In some cases, it can cause problems with bladder and bowel function.
    An increase in pressure in or on the cyst may increase symptoms and cause nerve damage. Symptoms can vary from person to person.
    If you have any of these symptoms, do not assume it is due to Tarlov cysts. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
    • 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 (sacral area)
    • Abnormal sensations in the legs and feet, or less commonly in the arms and hands
    • Sciatica symptoms, such as pain when sitting or standing
    • Headaches
    • The feeling of “sitting on a rock”
    • Pulling and burning feeling in the tailbone
    • Loss of sensation on the skin
    • Loss of reflexes

    Diagnosis

    Your doctor will ask about your symptoms and medical history. She will also do a physical exam. Depending on your symptoms, you may need to see a specialist, such as a neurosurgeon.
    Tests may include the following imaging techniques:
    • MRI scan —a test that uses magnetic waves to make pictures of structures inside the body
    • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body
    • Myelogram —an imaging test that uses a special dye to view the spinal cord
    • Aspiration of the cyst—a needle is used to remove fluid from the cyst

    Treatment

    If you are experiencing symptoms, talk with your doctor about the best treatment plan for you.
    Treatment options might include:
    • Intramuscular corticosteroid injections or other medication injections —to relieve pain
    • Prescription medications —such as pain medications, antiseizure medications or antidepressants (both of these may be used to treat pain)
    • Lidoderm patches —applied to area of the spine where the cyst is located to provide temporary relief of pain and discomfort
    • Transcutaneous electrical nerve stimulation (TENS) —electrical impulses are delivered through the skin to help control pain
    • Nonsteroidal anti-inflammatory drugs (NSAIDs) —to relieve pain and inflammation
    • 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
    • Surgery —done if symptoms are severe; nerve damage is worsening; bowel and bladder dysfunction are worsening; or if there is wearing down of the sacrum or other spinal bones

    Prevention

    There are no guidelines to reduce your risk of forming a Tarlov cyst. If you have a Tarlov cyst that does not cause pain or other symptoms, avoiding injury or heavy lifting may reduce your chance of developing pain or other symptoms.

    RESOURCES

    National Institutes of Health http://www.nih.gov/

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

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

    CANADIAN RESOURCES

    HealthLinkBC http://www.healthlinkbc.ca/

    MyHealthAlberta.ca https://myhealth.alberta.ca/

    References

    American Academy of Neurology Foundation. Tarlov cysts. American Academy of Neurology Foundation website. Available at: http://www.thebrainmatters.org/disorders/index.cfm?event=view&disorder%5Fid=1082 . Accessed May 12, 2009.

    American Association of Neurological Surgeons. Tarlov cyst. American Association of Neurological Surgeons website. Available at: http://www.neurosurgerytoday.org/what/patient%5Fe/tarlov%5Fcyst06.asp . Updated November 2006. Accessed June 15, 2010.

    Mayo Clinic. Tarlov cysts: a cause of low back pain? Mayo Clinic website. Available at: http://www.mayoclinic.com/health/tarlov-cysts/AN01603 . Updated May 22, 2009. Accessed May 12, 2009.

    National Institute for Health and Clinical Excellence. Therapeutic percutaneous image-guided aspiration of spinal cysts. National Institute for Health and Clinical Excellence website. Available at: http://www.nice.org.uk/nicemedia/pdf/IPG223guidance.pdf . Updated August 2007. Accessed May 12, 2009.

    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 March 12, 2009. Accessed May 12, 2009.

    Tarlov Cyst Disease Foundation. Tarlov cyst information. Tarlov Cyst Disease Foundation website. Available at: http://www.tarlovcystfoundation.org/TarlovCystInformation.asp . Accessed June 10, 2010.

    Revision Information

  • Join WellZones today.

    Make a Change For LifeLearn more

    Wellmont LiveWell is creating a new tradition of wellness in the mountains by providing individuals with tools and encouragement to live healthier lifestyles.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease early and prevent heart attacks with HeartSHAPE® - a painless, non-invasive test that takes pictures of your heart to scan for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.


  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.