Tarlov cysts refer to a very serious medical condition that one could suffer from. These are primarily the development of fluid filled sacs that tend to affect the root of the nerve of the spine, which is also known as the sacral region – hence the name ‘sacral Tarlov cysts’. Although Tarlov cysts would also be considered as asymptomatic – which means that they generally have no symptoms, some Tarlov cyst symptoms may occur as a result of certain factors such as the size and specific location of the growth. A number of patients are known to suffer from more than one cyst being present on their spine and in multiple locations as well. Studies have shown that cysts that tend to be any bigger than about 1.5 centimeters would mostly tend to develop symptoms of their existence. Cysts can be identified as falling into three main types of lesions – with Tarlov cysts being classified as the type II variants.
For a better understanding into the various types of lesions, we shall explore their definitions a little more in depth. Type I lesions are also known as extra dural lesions and are characterized by the absence of nerve roots as well as considered to be of congenital origin which develops from the person’s dural sac area and are linked with a small collar. The type II variants, which is the classification that Tarlov cysts fall into, are also extra dural, but with roots and will tend to develop in numbers rather than in singles. Nerve fibers are usually present and inside the walls. These types of cysts tend to be significantly smaller in the higher sachral area, while being substantially bigger in the lower region of the sacrum. Some of the relatively large Tarlov cysts would mostly measure up to about 3 centimeters. The Type III variants of cysts could either be congenital, although more often caused by trauma. These types of cysts are considered to be a relatively rare development, of which around 75% could be seen within the dorsal area of the spine. The congenital versions of the type III cysts will usually be seen in the posterior part of the individual’s spinal cord while the traumatic ones will be seen in the anterior of the cord.
Tarlov cyst treatment will usually revolve around making sure that you contain and eradicate the Tarlov Cyst pain that the individual will be experiencing through the ordeal. Tarlov Cysts will usually develop in ‘walls’ and each of these walls tend to be rather thin and fibrous. They are also extremely tender to the touch – which is what makes Tarlov cyst surgery such a complication procedure. These nerve fibers present in the Tarlov cysts will resemble dental floss while they will not seem to be set in any particular pattern. The outer wall of a Tarlov cyst is made up of mainly the vascular connective tissue while the wall on the inside is ruled some flattened arachnoid tissue. As mentioned previously, despite the fact that these cysts are considered to be asymptomatic, the larger ones will usually develop symptoms. Some of the more common Tarlov cyst symptoms include sciatica, severe back pain, urinary incontinence, radicular pain, parethesia and sensory changes in the buttocks amongst many others.
Despite the fact that the cysts are relatively common as far as the development of spinal cysts go, there is not a whole lot of information available on the causing factors of their development. So far, most of the ideologies are nothing more than simple theories that have never been disproved or challenged. For instance, Tarlov himself was of the opinion that these perineurial cysts would develop due to the venous dranage being blocked in the perineurium and epineurium. Misdiagnosis is a rather common occurrence when it comes to Tarlov cysts because some of the medical experts are unable to distinguish whether the cysts contain any nerve fibers. As a result, it is important to make sure you have your condition looked at by a specialist.
There are two commonly used methods of diagnosis – an MRI scan and a CT scan, which are both imaging procedures that will allow the physician to detect the presence of any extradural spinal masses such as a Tarlov Cyst. Tarlov cyst surgery will take into account all the diagnosis information that has been gathered. This information includes an MRI scan indicating the presence of the cyst. These images will also clearly whether the cyst is larger than 1.5 centimeters in diameter or not. The doctor would also take note of any neurological symptoms and signs that are a direct result of the cyst as it plays a very prominent role in the individual’s lifestyle, and may also require some kind of surgical treatment. Care should also be taken to see if there is little or no response to physical or medical therapy and no contraindications to the surgery. As one can see, Tarlov Cyst surgery requires some extensive treatment to already be performed on the problem and is never considered to be a first option.
answered by G M