What is a Tarlov cyst?
Fluid-filled sacs found on the nerve roots extending out from the spinal cord are called Tarlov cysts. The fluid within the cyst is usually cerebrospinal fluid, which is the clear liquid surrounding the brain and spinal cord.
Cysts are most commonly seen in the lower back. They can form after an injury. Additionally, multiple cysts may appear simultaneously.
The size of Tarlov cysts varies. A significant number of cysts do not cause symptoms. As a result, they are often discovered incidentally while investigating another spine issue. If the cysts enlarge, symptoms such as pain, bowel and bladder problems, and numbness may occur. Tarlov cysts are also known as meningeal cysts or perineural cysts.
Causes of Tarlov cysts
The exact cause of Tarlov cysts is not fully understood. However, research suggests they may form in the following ways:
- Cerebrospinal fluid leakage often resulting from traumatic spinal injury
- Inflammation of the protective sheath surrounding the nerve root
Cerebrospinal fluid pressure can cause the size of a Tarlov cyst to change. Fluctuations in CSF pressure are normal. When the pressure increases, the cyst may also enlarge. Changes in pressure can be noticeable during strenuous activities like lifting heavy objects. This can worsen symptoms or make them more apparent.
Risk factors for Tarlov cysts
Anyone can develop a Tarlov cyst. However, the risk may be higher in the following situations:
- Spinal injury
- Marfan syndrome or Ehlers-Danlos syndrome, connective tissue disorders
- Being female
- Being between 30 and 60 years old
Symptoms of Tarlov cysts
Symptoms caused by Tarlov cysts depend on the size and location of the cyst. However, symptoms are observed in 5% to 8% of patients. Larger cysts tend to show symptoms more frequently. Possible symptoms include:
- Lower back pain
- Shocking or debilitating sensation along the leg and lower back
- Numbness, weakness, and loss of sensation in the legs
- Loss of bladder and bowel control
- Constipation
- Headaches
- Sexual dysfunction
Complications of Tarlov cysts
Tarlov cysts rarely cause complications. Possible complications include:
- Chronic pain
- Osteoporosis
- Permanent nerve damage
- Difficulty in movement
- Cyst rupture and bleeding
If complications occur, adjustments to daily routines may be necessary. Many people experience mental health issues such as depression due to the long-term effects of symptoms.
Diagnosis of Tarlov cysts
A Tarlov cyst diagnosis is usually made after a neurological examination and physical examination. To confirm the diagnosis, an imaging test like MRI or CT scan may be performed. Imaging tests can help understand the cyst and the nerve it affects. Additionally, a Tarlov cyst may be discovered incidentally during an MRI scan performed for reasons like back pain.
Treatment options for Tarlov cysts
If a Tarlov cyst does not cause symptoms, no treatment is applied. However, as age progresses and the cyst enlarges, symptoms may arise, necessitating regular monitoring.
If the cyst causes symptoms, treatments aimed at alleviating those symptoms are planned. Treatment varies depending on the symptoms observed in the patient.
Medication
Various medications are used to relieve pain and other symptoms. These medication groups may include anti-inflammatory drugs, pain relievers, and specific medications for nerve pain.
Tarlov cyst physical therapy
Physical therapy is used not only to strengthen muscles but also to manage pain.
Tarlov cyst injection
In some cases, various neurological procedures are available to drain the cysts to reduce pressure on the nerves.
Tarlov cyst surgery
If symptoms are severe and other treatment methods are ineffective, surgical intervention may be recommended. The cyst may be surgically removed or drained.
Benefits of Tarlov cyst surgery
If Tarlov cyst symptoms are severe or unresponsive to other treatments, the patient's quality of life may be significantly affected. Surgical interventions can help eliminate these symptoms and relieve the patient's complaints.
Complications of Tarlov cyst surgery
The most common complication after Tarlov cyst surgery is cerebrospinal fluid leakage. However, this condition heals on its own. To prevent this complication, it is recommended that patients rest in bed during the recovery process and elevate their legs. Additionally, a corset is recommended to prevent swelling.
There is also a risk of bacterial meningitis. Finally, in some patients, symptoms may worsen.
Tarlov cyst recovery process
When medication is used to manage symptoms caused by a Tarlov cyst, relief is usually seen within a short period. In some cases, symptom relief may take weeks. In some individuals, relief may not be seen even after cyst decompression or removal.
