(Perineural Cyst; Sacral Nerve Root Cyst)
Tarlov cysts are abnormal sacs of spinal fluid that usually form at the lower end of the spine (sacrum). What distinguishes Tarlov cysts is the presence of spinal nerve fibers either within the cyst wall or in the cyst.
The cause of a Tarlov cyst is unknown but may be related to:
- Trauma to the spine
- Increase in cerebrospinal fluid pressure
- Blockage of cerebrospinal fluid
Once you have a Tarlov cyst, the following may cause it to become painful:
Although gender may not be a risk factor, Tarlov cysts have more often been found in women than men.
Most of the time Tarlov cysts do not cause symptoms. Cysts may cause pain and other signs of nerve irritation, such as weakness or numbness. In some cases, it can cause problems with bladder and bowel function.
An increase in pressure in or on the cyst may increase symptoms and cause nerve damage. Symptoms can vary from person to person.
If you have any of these symptoms, do not assume it is due to Tarlov cysts. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:
- Bladder or bowel dysfunction
- Sexual dysfunction
- Nerve pain
- Pain in the lower back, buttocks, legs and feet, vagina, rectum, or abdomen
- Pain when coughing or sneezing
- Weakness, cramping, or numbness in the buttocks, legs, and feet
- Swelling, soreness, or tenderness around the lower end of the spine (sacral area)
- Abnormal sensations in the legs and feet
- Sciatica symptoms, such as pain when sitting or standing
- The feeling of “sitting on a hard surface”
- Pulling and burning feeling in the tailbone
- Loss of sensation on the skin
- Loss of reflexes
Your doctor will ask about your symptoms and medical history. She will also do a physical exam. Depending on your symptoms, you may need to see a specialist, such as a neurosurgeon.
Tests may include the following imaging techniques:
If you are experiencing symptoms, talk with your doctor about the best treatment plan for you.
Treatment options include:
- Intramuscular corticosteroid injections or other medication injections—to relieve pain
- Prescription medications—such as pain medications, antiseizure medications or antidepressants (both of these may be used to treat pain)
- Lidoderm patches—applied to area of the spine where the cyst is located to provide temporary relief of pain and discomfort
- Transcutaneous electrical nerve stimulation (TENS)—electrical impulses are delivered through the skin to help control pain
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
- Aspiration of the cyst plus fibrin glue injection—a needle is used to drain the cyst and then a special glue is used to prevent it from filling again
Surgery may be done if symptoms are severe and the cyst has caused pressure on a nerve or erosion of the spinal column bones.
National Institutes of Health
National Institute of Neurological Disorders and Stroke
Tarlov Cyst Disease Foundation
Women's Health Matters
Tarlov cysts. American Academy of Neurology Foundation website. Available at: http://www.thebrainmatters.org/disorders/index.cfm?event=view&disorder_id=1082. Accessed May 12, 2009.
Tarlov cyst. American Association of Neurological Surgeons website. Available at: http://www.neurosurgerytoday.org/what/patient_e/tarlov_cyst06.asp. Updated November 2006. Accessed June 15, 2010.
Tarlov cysts: a cause of low back pain? Mayo Clinic website. Available at: http://www.mayoclinic.com/health/tarlov-cysts/AN01603 . Updated May 22, 2009. Accessed May 12, 2009.
Tarlov cyst information. Tarlov Cyst Disease Foundation website. Available at: http://www.tarlovcystfoundation.org/TarlovCystInformation.asp. Accessed June 10, 2010.
Tarlov cyst information page. National Institute of Neurological Disorders and Stroke website. Available at: http://www.ninds.nih.gov/disorders/tarlov_cysts/tarlov_cysts.htm. Updated March 12, 2009. Accessed May 12, 2009.
Therapeutic percutaneous image-guided aspiration of spinal cysts. NHS National Institute for Health and Clinical Excellence website. Available at: http://www.nice.org.uk/nicemedia/pdf/IPG223guidance.pdf. Updated August 2007. Accessed May 12, 2009.
Last reviewed June 2010 by
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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