Abstract
Tarlov cyst syndrome is a rare, often asymptomatic disorder, characterised by isolated or multiple nerve-root cysts, usually occurring in the sacral spine, near the dorsal root ganglion, between the perineurium and endoneurium. The cysts may cause lower back pain, sacral radiculopathy, dyspareunia and urinary incontinence. There is little data in the literature on the relationship between Tarlov cysts and symptoms. Here, we report further details on the clinical impact of Tarlov cysts and investigate their pathogenesis and role as a cause of lumbosacral symptoms. We examined 157 patients with MRI evidence of symptomatic Tarlov cysts. Patients underwent complete neurological examination and were scored by the Hamilton Depression Rating Scale and the Visual Analogue Scale. Complete lower limb electromyography was performed in 32 patients. Clinical picture was correlated with size and number of cysts detected by MRI. Family history was recorded for signs of genetic inheritance. Almost all patients suffered perineal or lower back pain; 34 complained of sphincter and 46 of sexual disorders. Hamilton scores were abnormal, and family history was positive in a few cases. The scanty literature on Tarlov cysts mainly regards therapy by a neurosurgical approach. Our results provide new data on clinical impact and possible pathogenetic mechanisms.
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References
Tarlov IM (1938) Perineurial cysts of the spinal nerve roots. Arch Neurol Psychiatr 40:1067–1074
Tarlov IM (1952) Cysts of the sacral nerve roots. Arch Neurol Psychiatry 68:94–108
Tarlov IM (1970) Spinal perineurial and meningeal cysts. J Neurol Neurosurg Psychiatry 33:833–843
Nabors MW, Pait TG, Byrd EB, Karim NO, Davis DO, Kobrine AI et al (1988) Updated assessment and current classification of spinal meningeal cysts. J Neurosurg 68:366–377
Park HJ, Kim IS, Lee SW, Son BC (2008) Two cases of symptomatic perineural cysts (Tarlov cysts) in one family: a case report. J Korean Neurosurg Soc 44(3):174–177
H’ng MW, Wanigasiri UI, Ong CL (2009) Perineural (Tarlov) cysts mimicking adnexal masses: a report of three cases. Ultrasound Obstet Gynecol 34(2):230–233
Paulsen RD, Call GA, Murtagh FR (1994) Prevalence and percutaneous drainage of cysts of the sacral nerve root sheath (Tarlov cysts). Am J Neuroradiol 15:293–299
Nadler SF, Bartoli LM, Stitik TP, Chen B (2001) Tarlov cyst as a rare cause of S1 radiculopathy: a case report. Arch Phys Med Rehabil 82(5):689–690
Lucantoni C, Than KD, Wang AC, Valdivia–Valdivia JM, Maher CO, La Marca F, Park P (2011) Tarlov cysts: a controversial lesion of the sacral spine. Neurosurg Focus 31(6):E14
Singh PK, Singh VK, Azam A, Gupta S (2009) Tarlov cyst and infertility. J Spinal Cord Med 32(2):191–197
Acosta FL Jr, Quinones-Hinojosa A, Schmidt MH, Weinstein PR (2003) Diagnosis and management of sacral Tarlov cysts: case report and review of the literature. Neurosurg Focus 15:E15
Sajko T, Kovać D, Kudelić N, Kovac L (2009) Symptomatic sacral perineurial (Tarlov) cysts. Coll Antropol 33(4):1401–1403
Kumpers P, Wiesemann E, Becker H, Haubitz B, Dengler R, Zermann DH (2006) Sacral nerve root cysts—a rare cause of bladder dysfunction. Case report and review of the literature. Aktuelle Urol 37:372–375
Shinomiya K, Mutoh N, Furuya K (1994) Giant sacral cysts with neurogenic bladder. J Spinal Disord 7:444–448
Langdown AJ, Grundy JR, Birch NC (2005) The clinical relevance of Tarlov cysts. J Spinal Disord Tech 18:29–33
Hiers RH, Long D, North RB, Oaklander AL (2010) Hiding in plain sight: a case of Tarlov perineural cysts. J Pain 11(9):833–837 Review
Slipman CW, Bhat AL, Bhagia SM, Issac Z, Gilchrist RV, Lenrow DA (2003) Abdominal pain secondary to a sacral perineural cyst. Spine J 3(4):317–320
Mitra R, Kirpalani D, Wedemeyer M (2008) Conservative management of perineural cysts. Spine (Phila Pa 1976) 33:E565–E568
Kunz U, Mauer UM, Waldbaur H (1999) Lumbosacral extradural arachnoid cysts: diagnostic and indication for surgery. Eur Spine J 8:218–222
Voyadzis JM, Bhargava P, Henderson FC (2001) Tarlov cysts: a study of 10 cases with review of the literature. J Neurosurg 95(1 Suppl):25–32
Mummaneni PV, Pitts LH, McCormack BM, Corroo JM, Weinstein PR (2000) Microsurgical treatment of symptomatic sacral Tarlov cysts. Neurosurgery 47:74–79
Mondelli M, Romano C, Della Porta PD, Rossi A (1995) Electrophysiological evidence of “nerve entrapment syndromes” and subclinical peripheral neuropathy in progressive systemic sclerosis (scleroderma). J Neurol 242(4):185–194
Kim K, Chun SW, Chung SG (2012) A case of symptomatic cervical perineural (Tarlov) cyst: clinical manifestation and management. Skeletal Radiol 41(1):97–101
Cattaneo L, Pavesi G, Mancia D (2001) Sural nerve abnormalities in sacral perineural (Tarlov) cysts. J Neurol 248(7):623–624
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Marino, D., Carluccio, M.A., Di Donato, I. et al. Tarlov cysts: clinical evaluation of an italian cohort of patients. Neurol Sci 34, 1679–1682 (2013). https://doi.org/10.1007/s10072-013-1321-0
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DOI: https://doi.org/10.1007/s10072-013-1321-0