Tarlov cysts, also known as sacral nerve root cysts or perineural cysts are the cerebrospinal fluid dilations of the nerve root sheaths most commonly at the sacral level of the spine. The condition may cause progressive pain and discomfort. The condition is present in about 5-6 % of the general population however it is more common in women as compared to men. The perineural cyst can form in any section of the spine including cervical, thoracic, lumbar, and sacral.
The symptoms of tarlov cysts may vary depending on the location of the cysts in the spine. The most common symptoms include pain in lower back, discomfort and pain while sitting or standing or coughing, pain in legs or chest or upper back or neck or arms, dizziness or lack of balance. Other signs and symptoms may also include ear noises, blurred visions, headaches , vaginal or abdominal pain, 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.
Scientist are still unsure about the actual causes of tarlov cysts; however several experts believe that conditions that may increase the spinal fluid pressure also 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.
Since the actual cause of the condition is unknown, it is very difficult to quickly diagnose the condition. Moreover the condition occurs close to the lower pelvic region which makes the diagnosis of the condition very difficult. Usually men with tarlov cysts are misdiagnosed with herniated lumbar discs, arachnoiditis, while women are misdiagnosed with gynecological conditions. 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. Magnetic resonance imaging, computed tomographic and myelography tests can be helful in diagnosing the condition. Another condition affecting the same region may further complicate the diagnosis.
The treatment of the condition may include nonsurgical procedures such as drainage of the cerebrospinal fluid, cyst aspiration and replacing cerebrospinal fluid inside the with fibrin glue. However such therapies may not prevent symptomatic cyst recurrence, therefore surgery is the most recommended treatment for the problem.
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