Clinical NotesTarlov cyst as a rare cause of S1 radiculopathy: A case report☆,☆☆
Section snippets
Case report
A 37-year-old female physician presented with a 4-month history of left posterior thigh pain. She was initially evaluated by an orthopedic surgeon, who ordered magnetic resonance imaging (MRI) of the lumbosacral spine. According to the patient, the MRI scan was reported to be within normal limits, with the exception of minimal disc bulging at L4-5. She received physical therapy for suspected disc pathology with little benefit and was subsequently referred for physiatric assessment.
Her pain was
Discussion
Tarlov's initial descriptions of perineurial cysts were primarily localized to the posterior sacral or coccygeal nerve roots, most often the second or third sacral roots.1, 2, 3, 5 On very rare occasions, these cysts were also observed in the thoracic spine.3 These cysts generally occur at the junction of the posterior root and the dorsal ganglion, and are located between the perineurium and endoneurium. They are filled with cerebrospinal fluid (CSF) and are static in size. Histologic
Conclusions
Tarlov cysts are a rare cause of low back pain or lumbosacral radiculopathy and should be considered in the differential diagnosis of radicular symptoms. MRI is the radiologic study of choice to visualize these cysts. CT-guided percutaneous drainage offers an alternative to extensive sacral laminectomies with cyst excision, although simple monitoring may be acceptable in the minimally involved individual.
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Cited by (34)
Symptomatic Tarlov Cysts: Surgical Treatment by Subcutaneous Infusion Port
2018, World NeurosurgeryCitation Excerpt :CSF is capable of running into the cyst with arterial pulsation, but discharge is limited due to a ball-valve phenomenon.10 Case reports and reviews recommend that any reasons that can increase CSF’s intracystic hydrostatic pressure can be conducive to cystic development, which can lead to compression of nerve roots and spinal nerves and extension of nerve tissues within the cysts, both of which can create neuropathic pain.4-6,11,12 Currently, it is controversial with respect to the optimum treatment option for symptomatic TCs.
Tarlov cyst: A case report
2016, FMC Formacion Medica Continuada en Atencion PrimariaSymptomatic Tarlov cyst and electroacupuncture: More studies required
2015, Journal of Integrative MedicineCauda equina syndrome secondary to bilateral sacral Tarlov cysts
2014, Spine JournalTarlov cyst: Diagnosis during the postpartum period
2014, Clinica e Investigacion en Ginecologia y ObstetriciaSciatica due to unusual causes: Tarlov cysts and nerve roots anomalies
2009, Revue Neurologique
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Reprint requests to Scott F. Nadler, DO, 90 Bergen St, Newark, NJ 07103.