Tarlov cysts, also known as sacral nerve root cysts or perineural cysts, are the cerebrospinal fluid dilations of the nerve root sheaths at the dorsal root ganglion and can cause progressive nerve pain. Tarlov cystam can occur in anyone however they are more common in women. They are present in around 5-6 % of the general population. The perineural cyst can form in any section of the spine including cervical, thoracic, lumbar, and sacral.
The actual causes of tarlov cysts are still unknown; however several conditions can increase the spinal fluid pressure that may increase the risk for tarlov cysts. Trauma to the spinal cord and collagen mutations or connective tissue disorders may contribute to the development of the cysts.
The symptoms of tarlov cysts occur due to the compression of the roots of the nerves and may vary depending on the location in the section of the spine. The most common symptoms include pain in lower back or legs or chest or upper back or neck or arms, discomfort and pain while sitting or standing or coughing, dizziness or lack of balance.
Other signs and symptoms may also include vaginal or abdominal pain, ear noises, headaches, blurred visions, restless leg syndrome, loss of sensation on the skin, changes in bowel function, changes in bladder function, changes in sexual function, and loss of reflexes.
Since the actual cause of the condition is unknown, it becomes very difficult to diagnose the condition because of the limited knowledge. Most of the symptoms of the condition are also common to several other conditions which make it hard to guess Tarlov cysts as the reason behind the symptoms. However an experienced neurosurgeon with lot experience treating the condition will recommend magnetic resonance imaging for a patient who has lower back pain. Computed tomographic and myelography tests are also done to confirm the observation.
Common nonsurgical treatments for the condition include drainage of the cerebrospinal fluid and cyst aspiration. A newer technique involves filling the empty space of the cyst with substance such as fibrin glue injection after removing the cerebrospinal fluid from inside the cyst. However such therapies may not prevent symptomatic cyst recurrence.
Other option is to perform a surgery to expose the region of the spine with the cyst and drain the the fluid out. The cyst is then occluded with a fibrin glue injection to to prevent the fluid from returning.
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