Management of Tarlov cysts: an uncommon but potentially serious spinal column disease—review of the literature and experience with over 1000 referrals

Abstract

Tarlov cysts were thought to be anatomic variants of uncertain etiology and clinical significance when initially described over 80 years ago. They are often detected in routine lumbosacral imaging and generally not reported in a differential diagnosis. There is increasing evidence that at least some Tarlov cysts are symptomatic and can have a significant adverse impact on patients’ health and well-being. Women are disproportionately affected with this condition, often presenting with long-standing pain and neurological dysfunctions. Significant gender bias has been a concern in the management of these patients. Unfortunately, there is no consensus on patient selection or management approaches for symptomatic Tarlov cysts. This review article updates information on the prevalence, diagnosis, clinical significance, and treatments of these cysts. Based on these findings and experience with over 1000 patient referrals, a treatment decision algorithm for symptomatic Tarlov cysts was constructed to provide guidance for appropriate management of patients with these complex cysts.

Symptomatic lumbar Tarlov cyst resolution after computed tomography-guided percutaneous trans-sacral fibrin glue intracystic injection: A case report and literature review

“…Minimally invasive percutaneous techniques utilized to treat TC may include cyst aspiration or two-needle-aspiration and fibrin glue injection under CT guidance. [ 1 - 3 ] Myelography is essential to evaluate the subarachnoid connections with TC to distinguish these from intradural ectasias, subarachnoid cysts, and meningeal diverticula; specifically, myelo-CT studies must rule out significant communication between the cyst and the subarachnoid space. [ 6 , 8 ] In our case, both the contrast-enhanced MRI and intra-procedural injection of iodinated contrast documented the absence of any wide communication between the cyst and the subarachnoid space.…”

Meningocele Intra-Sacral Oculta: um relato de caso

“…A RM é considerada o exame padrão-ouro para o diagnóstico definitivo de cistos intrasacrais, permitindo a visualização detalhada do cisto e suas relações anatômicas com estruturas adjacentes 5 . O manejo depende da gravidade dos sintomas neurológicos e das características do cisto, incluindo seu tamanho e localização 5,6 . Em casos assintomáticos ou com sintomas leves, o acompanhamento clínico periódico pode ser suficiente 5,6 .…”

“…O manejo depende da gravidade dos sintomas neurológicos e das características do cisto, incluindo seu tamanho e localização 5,6 . Em casos assintomáticos ou com sintomas leves, o acompanhamento clínico periódico pode ser suficiente 5,6 . No entanto, em pacientes com Brazilian Journal of Health Review, Curitiba, v. 7, n. 3, p. 01-06, may/jun., 2024 sintomatologia neurológica progressiva, cistos volumosos (>5cm) ou hidrocefalia associada, a intervenção cirúrgica pode ser indicada 6,7 .…”

Successful Conservative Management of a Patient With Symptomatic Cervical Perineural Cysts: A Case Report

“…They present as single or multilevel cysts, mainly at the sacral level, but have also been reported to exist at other spinal levels, particularly the cervical level. The prevalence of Tarlov cysts in the sacral region in the general population ranges from 1.5% to 13.2% and appears to be more common in women [8].…”