Tags

Type your tag names separated by a space and hit enter

Can patients with symptomatic Tarlov cysts be differentiated from patients with specific low back pain based on comprehensive history taking?
Acta Neurochir (Wien) 2018; 160(4):839-844AN

Abstract

BACKGROUND

Tarlov cysts (TCs) are expanded nerve root sheaths that occur near the dorsal root ganglion and result from increased intraspinal hydrostatic pressure. TCs most frequently affect the lumbosacral plexus and therefore may cause specific symptoms such as perineal pain and neurogenic bladder, bowel, and sphincter problems. It has been estimated that 1% of the population has symptomatic Tarlov cysts (STCs). However, STCs appear to be underdiagnosed, with the pain reported by patients commonly attributed to degenerative alterations seen on MRI. The aim of the present study is to investigate the utility of a comprehensive questionnaire for use by physicians in establishing the diagnosis of STCs.

METHODS

We compared questionnaire responses regarding patient history between 33 patients diagnosed with symptomatic TCs and 42 patients with chronic low back pain and sciatica due to disc problems or degenerative or inflammatory disorders. The diagnosis of STCs was confirmed using nerve conduction studies (NCS) and electromyography (EMG) of the sacral myotomes by an expert neurophysiologist.

RESULTS

The questionnaire responses revealed specific differences in perineal symptoms (perineal pain, dyspareunia, coccygodynia), bowel symptoms (constipation, diarrhea), bladder symptoms (hesitation, retention, frequency), and anal sphincter problems (anal pain, mild fecal incontinence). Additionally, sitting, walking, and straining aggravated pain more frequently in STC patients, and STC patients were more often forced to stop working and/or reduce their social activities.

CONCLUSIONS

Including the above-listed items in the patient history might facilitate differentiation of low back pain and sciatica due to STCs from that due to disc problems or degenerative or inflammatory disorders.

Authors+Show Affiliations

Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven, Tervuursevest 101, 3001, Heverlee, Belgium. miekehulens@skynet.be. Department of Neurosurgery, ZNA Middelheim, Lindendreef 1, 2020, Antwerp, Belgium. miekehulens@skynet.be.Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven, Tervuursevest 101, 3001, Heverlee, Belgium.Department of Neurosurgery, ZNA Middelheim, Lindendreef 1, 2020, Antwerp, Belgium.Clinical Electromyography Laboratory, University Hospitals UZ Leuven, Herestraat 49, 3000, Leuven, Belgium.Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven, Tervuursevest 101, 3001, Heverlee, Belgium.Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, University of Leuven, Tervuursevest 101, 3001, Heverlee, Belgium.Department of Social and Primary Health Care, Public Health Nutrition, University of Leuven, Herestraat 49, 3000, Leuven, Belgium.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

29455410

Citation

Hulens, Maria Anna, et al. "Can Patients With Symptomatic Tarlov Cysts Be Differentiated From Patients With Specific Low Back Pain Based On Comprehensive History Taking?" Acta Neurochirurgica, vol. 160, no. 4, 2018, pp. 839-844.
Hulens MA, Dankaerts W, Rasschaert R, et al. Can patients with symptomatic Tarlov cysts be differentiated from patients with specific low back pain based on comprehensive history taking? Acta Neurochir (Wien). 2018;160(4):839-844.
Hulens, M. A., Dankaerts, W., Rasschaert, R., Bruyninckx, F., Willaert, M. L., Vereecke, C., & Vansant, G. (2018). Can patients with symptomatic Tarlov cysts be differentiated from patients with specific low back pain based on comprehensive history taking? Acta Neurochirurgica, 160(4), pp. 839-844. doi:10.1007/s00701-018-3494-z.
Hulens MA, et al. Can Patients With Symptomatic Tarlov Cysts Be Differentiated From Patients With Specific Low Back Pain Based On Comprehensive History Taking. Acta Neurochir (Wien). 2018;160(4):839-844. PubMed PMID: 29455410.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Can patients with symptomatic Tarlov cysts be differentiated from patients with specific low back pain based on comprehensive history taking? AU - Hulens,Maria Anna, AU - Dankaerts,Wim, AU - Rasschaert,Ricky, AU - Bruyninckx,Frans, AU - Willaert,Marie-Laure, AU - Vereecke,Charlotte, AU - Vansant,Greet, Y1 - 2018/02/17/ PY - 2017/07/06/received PY - 2018/02/10/accepted PY - 2018/2/20/pubmed PY - 2019/5/17/medline PY - 2018/2/19/entrez KW - Ischialgia KW - Non-specific low back pain KW - Perineal pain KW - Tarlov cysts SP - 839 EP - 844 JF - Acta neurochirurgica JO - Acta Neurochir (Wien) VL - 160 IS - 4 N2 - BACKGROUND: Tarlov cysts (TCs) are expanded nerve root sheaths that occur near the dorsal root ganglion and result from increased intraspinal hydrostatic pressure. TCs most frequently affect the lumbosacral plexus and therefore may cause specific symptoms such as perineal pain and neurogenic bladder, bowel, and sphincter problems. It has been estimated that 1% of the population has symptomatic Tarlov cysts (STCs). However, STCs appear to be underdiagnosed, with the pain reported by patients commonly attributed to degenerative alterations seen on MRI. The aim of the present study is to investigate the utility of a comprehensive questionnaire for use by physicians in establishing the diagnosis of STCs. METHODS: We compared questionnaire responses regarding patient history between 33 patients diagnosed with symptomatic TCs and 42 patients with chronic low back pain and sciatica due to disc problems or degenerative or inflammatory disorders. The diagnosis of STCs was confirmed using nerve conduction studies (NCS) and electromyography (EMG) of the sacral myotomes by an expert neurophysiologist. RESULTS: The questionnaire responses revealed specific differences in perineal symptoms (perineal pain, dyspareunia, coccygodynia), bowel symptoms (constipation, diarrhea), bladder symptoms (hesitation, retention, frequency), and anal sphincter problems (anal pain, mild fecal incontinence). Additionally, sitting, walking, and straining aggravated pain more frequently in STC patients, and STC patients were more often forced to stop working and/or reduce their social activities. CONCLUSIONS: Including the above-listed items in the patient history might facilitate differentiation of low back pain and sciatica due to STCs from that due to disc problems or degenerative or inflammatory disorders. SN - 0942-0940 UR - https://www.unboundmedicine.com/medline/citation/29455410/Can_patients_with_symptomatic_Tarlov_cysts_be_differentiated_from_patients_with_specific_low_back_pain_based_on_comprehensive_history_taking L2 - https://dx.doi.org/10.1007/s00701-018-3494-z DB - PRIME DP - Unbound Medicine ER -