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Diseases

Genetic and Rare Diseases Information Center (GARD)

Tarlov cysts


Other Names for this Disease
  • Sacral Tarlov cysts
  • Sacral perineural cysts
  • Tarlov cyst
  • Perineural cysts
  • Sacral neural cysts
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.

Treatment

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How might Tarlov cysts be treated?

While there is no standard accepted treatment for individuals with symptomatic Tarlov cysts, many different therapies have been tried.[1] Tarlov cysts may be drained and shunted to relieve pressure and pain, but relief is often only temporary and fluid build-up in the cysts will recur. Corticosteroid injections may also temporarily relieve pain. Non-steroidal anti-inflammatory drugs (NSAIDS) may be prescribed to treat chronic pain and inflammation. Injecting the cysts with fibrin glue (a combination of naturally occurring substances based on the clotting factor in blood) may provide temporary relief of pain. Microsurgical removal of the cyst wall may be an option in select individuals who do not respond to conservative treatments and who continue to experience pain or progressive neurological damage.[1][2][3]  

Transcutaneous Electrical Nerve Stimulation (TENS) has been proven useful for some in pain management. TENS devices deliver electrical impulses through the skin to the nerves to control pain. Unlike medications and topical ointments, TENS does not have any known side effects, other than skin irritation from the electrodes in some patients.[3]

A recent review analyzed the different surgical options, including the following:[4]
  • Sacral laminectomy with microsurgical cyst fenestration and cyst imbrication
  • Sacral laminectomy with resection of the sacral cyst
  • Microsurgical excision of the cyst along with duraplasty or plication of the cyst
  • Release of the valve and imbrication of the sacral cysts with laminectomies
  • Total or partial cyst wall removal, arranging the remaining nerve sheath, and repairing the local defect with muscle, gelfoam and fibrin glue
  • Removing of the cyst and closure of defect by fibrin glue
  • Microscopic cyst resection and closure of defect by fibrin glue
  • Microsurgical fenestration from the cyst to the thecal sac
  • Fenestration of the cyst and closure of the opening by stitches and glue  
  • Cyst remodeling around the root using titanium clips
  • Cyst excision and occlusion of its neck.

The authors of this review concluded that the best results are obtained with the complete removal of the cyst and closure of the defect by fibrin glue, microscopic cyst resection and closure of the defect by fibrin glue, or cyst removal with closure of its neck.[4]

Last updated: 5/25/2016

References
  1. Weinstein PR. Tarlov Cysts. National Organization for Rare Disorders (NORD). 2015; http://rarediseases.org/rare-diseases/tarlov-cysts/.
  2. NINDS Tarlov Cysts Information Page. National Institutes of Neurological Disorders and Stroke (NINDS). June 14, 2012; http://www.ninds.nih.gov/disorders/tarlov_cysts/tarlov_cysts.htm.
  3. Tarlov Cyst Information. Tarlov Cyst Disease Foundation. http://www.tarlovcystfoundation.org/tarlov_cyst_information0.aspx. Accessed 3/28/2016.
  4. Elsawaf A, Awad TE & Fesal SS. Surgical excision of symptomatic sacral perineurial Tarlov cyst: case series and review of the literature. Eur Spine J. May 6, 2016; https://www.ncbi.nlm.nih.gov/pubmed/27154168.


Clinical Trials & Research for this Disease

  • The Tarlov Cyst Disease Foundation is conducting a Tarlov Cyst Patient Survey. The Tarlov Cyst Disease Foundation is a volunteer-based, 501(c)(3) non-profit foundation dedicated to the research, improved diagnosis, advocacy for patients, and development of successful treatments and outcomes for symptomatic Tarlov cysts. Click on Tarlov Cyst Patient Survey to learn more about how you can participate in Tarlov cyst research.
Other Names for this Disease
  • Sacral Tarlov cysts
  • Sacral perineural cysts
  • Tarlov cyst
  • Perineural cysts
  • Sacral neural cysts
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.