A systematic review of the efficacy of surgical intervention in the management of symptomatic Tarlov cysts: a meta-analysis

Kameda-Smith, Michelle; Fathalla, Zina; Nadeem, Irfan Ahmed; Astaneh, Behrooz; Farrokhyar, Forough

doi:10.1080/02688697.2021.1874294

Cited by 15 publications

(13 citation statements)

References 27 publications

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“…The latest meta-analysis found that patients who underwent surgical intervention had a postoperative complication rate of 16.9% (11.8–22.7) and a cyst recurrence rate of 8.5% (3.5–15.4). The most common complications were the occurrence of surgical site infection and/or cerebrospinal fluid leakage ( 41 ). Currently, surgery is the primary effective treatment for symptomatic STC.…”

Section: Discussionmentioning

confidence: 99%

A bibliometric and visualization study of global research trends in sacral Tarlov cyst from 2000 to 2022

Lu,

Bao,

Wang

et al. 2024

Front. Surg.

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BackgroundSymptomatic sacral Tarlov cyst (STC) exerts a significant negative impact on the patient's quality of life, highlighting the significance of the increasing number of studies on STC. However, bibliometric analyses in this research field are scarce. Thus, this study aims to provide a comprehensive knowledge structure and identify the research trends of STC through bibliometrics.MethodsArticles related to STC from 2000 to 2022 were sourced from the Web of Science Core Collection database. VOSviewer 1.6.16, CiteSpace 6.1.6, GraphPad Prism 8.2.1 and R-package “bibliometrix” were used to analyse the data and generate knowledge maps.ResultsA total of 930 studies on STC from 2000 to 2022 were included. The findings revealed a consistent yet upward trend in the number of annual publications in this field. The United States, China and Turkey were the most prolific and influential countries contributing to this field, with the University of Illinois, the University of Maryland and the National Institute of Standards & Technology being the most notable research institutions. Key journals include World Neurosurgery [Impact Factor (IF) = 2.210], Journal of Vascular Surgery (IF = 4.860) and Journal of Neurosurgery-Spine (IF = 3.467). Additionally, Tarlov Mj, Tarlov E and Zachariah Mr exhibit the highest number of publications, making them the leading authors in this field. A twenty-year retrospection of research trends using keyword analysis reveals four principal directions, namely “definition”, “pathogenesis”, “diagnosis” and “treatment”. Currently, therapeutic surgical intervention is the key treatment for this disease, with future treatments primarily hinging on minimally invasive methodologies rooted in microendoscopic and endoscopic techniques.ConclusionThis pioneering, comprehensive scientific bibliometric study provides a holistic summary of STC research trends and hot spots spanning the past 22 years. The results identify existing research frontiers and chart maps for future studies, serving as a valuable reference for scholars vested in this field.

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Section: Discussionmentioning

confidence: 99%

A bibliometric and visualization study of global research trends in sacral Tarlov cyst from 2000 to 2022

Lu,

Bao,

Wang

et al. 2024

Front. Surg.

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“…If symptoms persist despite medical management, nonsurgical management, such as epidural steroid injections and CT-guided aspiration, should be attempted. Surgical intervention may be pursued if other measures fail to relieve pain but should not be the initial treatment due to relatively high complication rates [7].…”

Section: Discussionmentioning

confidence: 99%

Spinal Cord Stimulation for the Treatment of Refractory Pain From Tarlov Cysts: A Case Report

On¹,

Gutierrez²,

Plaza-Lloret³

et al. 2023

Cureus

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Tarlov cysts are extradural meningeal cysts with a collection of cerebrospinal fluid that most often affects sacral nerve roots, causing chronic low back pain and radiculopathy. Still, there is no consensus regarding the best treatment for symptomatic cysts. We describe a patient who developed worsening lower back pain and radiculopathy after interventional drainage and surgical management. Medication and various procedures failed to relieve the pain. Subsequently, the patient received significant pain relief from spinal cord stimulation (SCS). This case provides evidence that SCS could be used to manage refractory pain from Tarlov cysts that have failed to respond to other treatment modalities.

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“…In this case, an iatrogenic SPF was caused by injury of the dural sleeve during thoracoscopic surgery after the misdiagnosis of a TC preoperatively; it is likely that the dural injury was concealed, with no obvious outflow of CSF during the surgery. It is important to note that CSF leakage can also occur when a definite diagnosis of TC has been made in advance, as CSF leakage is reported to be the most frequent complication of surgical interventions for TCs, as shown in a systematic review ( 19 ). This may be because an intercostal nerve dural sleeve tear is easily overlooked, as it can be obscured by fat or peridural venous oozing at the level of the neural foramen ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Epidural blood patches are effective in treating intracranial hypotension due to a subarachnoid-pleural fistula

et al. 2022

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BackgroundIntracranial hypotension (IH) is usually associated with cerebrospinal fluid (CSF) leakage and/or CSF hypotension, and epidural blood patch (EBP) therapy has been proven to be effective for treating spontaneous IH and post-dural puncture headaches. Tarlov cysts (TCs) are common lesions of the sacral spine. They have rarely been reported in thoracic locations and are even less common in the posterior mediastinum, which can lead to their misdiagnosis as neurogenic tumors.Case presentationHere, we report the case of a 60-year-old woman who developed an orthostatic headache after the thoracoscopic resection of a TC in the posterior mediastinum that was presumed to be a schwannoma preoperatively. The patient was finally diagnosed with IH caused by a subarachnoid-pleural fistula (SPF) and was cured by targeted EBP treatment.ConclusionThis is a case to show that a single targeted EBP treatment is effective for a patient with IH caused by an SPF after thoracoscopic resection of a TC. This case reminds us to be vigilant that a TC may be masquerading as a posterior mediastinal neurogenic tumor, and a detailed examination should be performed to identify it before deciding on a surgical procedure. In addition, postural headache after thoracoscopic spinal surgery should be alert to the possibility of IH induced by an SPF. Once it occurs, early treatment is necessary, and targeted EBP treatment can serve as a safe and effective alternative when conservative treatment fails.

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A systematic review of the efficacy of surgical intervention in the management of symptomatic Tarlov cysts: a meta-analysis

Cited by 15 publications

References 27 publications

A bibliometric and visualization study of global research trends in sacral Tarlov cyst from 2000 to 2022

A bibliometric and visualization study of global research trends in sacral Tarlov cyst from 2000 to 2022

Spinal Cord Stimulation for the Treatment of Refractory Pain From Tarlov Cysts: A Case Report

Case report: Epidural blood patches are effective in treating intracranial hypotension due to a subarachnoid-pleural fistula

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