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Tarlov cysts: a study of 10 cases with review of the literature.
J Neurosurg. 2001 Jul; 95(1 Suppl):25-32.JN

Abstract

OBJECT

Tarlov or perineurial cysts are lesions of the nerve root most often found in the sacral region. Although there is agreement that asymptomatic Tarlov cysts should be followed, it is still debated whether patients with symptomatic Tarlov cysts should be treated surgically. The authors assessed the outcome and efficacy of cyst wall resection in 10 patients with symptomatic Tarlov cysts. The medical literature is reviewed, theories of origin are evaluated, and suggestions as to their cause and pathogenesis are offered.

METHODS

Ten consecutive patients harboring symptomatic Tarlov cysts were treated by the senior author between 1989 and 1999. All patients were assessed for neurological deficits and pain by neurological examination and visual analog scale, respectively. Computerized tomography myelography was performed in all patients to diagnose delayed filling of the cysts. A sacral laminectomy with resection of the sacral cyst or cysts was performed in all patients. Resected material from eight of 10 patients was submitted for histopathological evaluation. Seven (70%) of 10 patients obtained complete or substantial resolution of their symptoms, with an average follow up of 31.7 months. All of these patients had Tarlov cysts larger than 1.5 cm in diameter, producing radicular pain or bladder and bowel dysfunction. Three (30%) of 10 patients experienced no significant improvement. All three patients harbored Tarlov cysts smaller than 1.5 cm in diameter, producing nonradicular pain. Histopathological examination was performed on specimens from eight of 10 patients, which demonstrated nerve fibers in 75% of cases, ganglion cells in 25% of cases, and evidence of old hemorrhage in half.

CONCLUSIONS

Large cysts (> 1.5 cm) and the presence of associated radicular symptoms strongly correlate with excellent outcome. Tarlov cysts may result from increased hydrostatic pressure and trauma.

Authors+Show Affiliations

Department of Neurosurgery and Pathology, Georgetown University Medical Center, Washington, DC, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

11453427

Citation

Voyadzis, J M., et al. "Tarlov Cysts: a Study of 10 Cases With Review of the Literature." Journal of Neurosurgery, vol. 95, no. 1 Suppl, 2001, pp. 25-32.
Voyadzis JM, Bhargava P, Henderson FC. Tarlov cysts: a study of 10 cases with review of the literature. J Neurosurg. 2001;95(1 Suppl):25-32.
Voyadzis, J. M., Bhargava, P., & Henderson, F. C. (2001). Tarlov cysts: a study of 10 cases with review of the literature. Journal of Neurosurgery, 95(1 Suppl), 25-32.
Voyadzis JM, Bhargava P, Henderson FC. Tarlov Cysts: a Study of 10 Cases With Review of the Literature. J Neurosurg. 2001;95(1 Suppl):25-32. PubMed PMID: 11453427.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tarlov cysts: a study of 10 cases with review of the literature. AU - Voyadzis,J M, AU - Bhargava,P, AU - Henderson,F C, PY - 2001/7/17/pubmed PY - 2001/8/3/medline PY - 2001/7/17/entrez SP - 25 EP - 32 JF - Journal of neurosurgery JO - J. Neurosurg. VL - 95 IS - 1 Suppl N2 - OBJECT: Tarlov or perineurial cysts are lesions of the nerve root most often found in the sacral region. Although there is agreement that asymptomatic Tarlov cysts should be followed, it is still debated whether patients with symptomatic Tarlov cysts should be treated surgically. The authors assessed the outcome and efficacy of cyst wall resection in 10 patients with symptomatic Tarlov cysts. The medical literature is reviewed, theories of origin are evaluated, and suggestions as to their cause and pathogenesis are offered. METHODS: Ten consecutive patients harboring symptomatic Tarlov cysts were treated by the senior author between 1989 and 1999. All patients were assessed for neurological deficits and pain by neurological examination and visual analog scale, respectively. Computerized tomography myelography was performed in all patients to diagnose delayed filling of the cysts. A sacral laminectomy with resection of the sacral cyst or cysts was performed in all patients. Resected material from eight of 10 patients was submitted for histopathological evaluation. Seven (70%) of 10 patients obtained complete or substantial resolution of their symptoms, with an average follow up of 31.7 months. All of these patients had Tarlov cysts larger than 1.5 cm in diameter, producing radicular pain or bladder and bowel dysfunction. Three (30%) of 10 patients experienced no significant improvement. All three patients harbored Tarlov cysts smaller than 1.5 cm in diameter, producing nonradicular pain. Histopathological examination was performed on specimens from eight of 10 patients, which demonstrated nerve fibers in 75% of cases, ganglion cells in 25% of cases, and evidence of old hemorrhage in half. CONCLUSIONS: Large cysts (> 1.5 cm) and the presence of associated radicular symptoms strongly correlate with excellent outcome. Tarlov cysts may result from increased hydrostatic pressure and trauma. SN - 0022-3085 UR - https://www.unboundmedicine.com/medline/citation/11453427/Tarlov_cysts:_a_study_of_10_cases_with_review_of_the_literature_ L2 - https://thejns.org/doi/10.3171/spi.2001.95.1.0025 DB - PRIME DP - Unbound Medicine ER -