Total Brain & Spine Institute is committed to providing the best care and treatment for Tarlov Cysts throughout Tampa, Florida. Dr. Le and his team are standing by the assist you.  Contact us today to schedule a consultation.

Tarlov cysts are fluid-filled nerve root cysts found most commonly at the sacral level of the spine – the vertebrae at the base of the spine. These cysts typically occur along the posterior nerve roots. Cysts can be valved or nonvalved. The main feature that distinguishes Tarlov cysts from other spinal lesions is the presence of spinal nerve root fibers within the cyst wall or in the cyst cavity itself.

Due to the close proximity to the lower pelvic region, patients may be misdiagnosed with herniated lumbar discs, arachnoiditis and in females, gynecological conditions. An accurate diagnosis may be further complicated if the patient has another condition that affects the same region.

Causes

Although the exact cause is unknown, there are theories as to what may cause an asymptomatic Tarlov cyst to produce symptoms. In several documented cases, accidents or falls involving the tailbone area of the spine caused previously undiagnosed Tarlov cysts to flare up.

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Symptoms

An increase in pressure in or on the cysts may increase symptoms and cause nerve damage. Sitting, standing, walking and bending are typically painful, and often, the only position that provides relief is reclining flat on one’s side. Symptoms vary greatly by patient and may flare up and then subside. Any of the following may be present in patients that have symptomatic Tarlov cysts:

  • Pain in the area of the nerves affected by the cysts, especially the buttocks
  • Weakness of muscles
  • Difficulty sitting for prolonged periods
  • Loss of sensation on the skin
  • Loss of reflexes
  • Changes in bowel function, such as constipation
  • Changes in bladder function, including increased frequency or incontinence
  • Changes in sexual function

Diagnosis

Tarlov cyst is difficult to diagnose because of the limited knowledge about the condition and because many of the symptoms can mimic other disorders. Most primary care physicians would not consider the possibility of Tarlov cyst. It is best to consult a neurosurgeon with experience in treating this condition.

Tarlov cysts may be discovered when patients with low back pain or sciatica have a magnetic resonance imaging (MRI) performed. Follow-up radiological studies, in particular, computed tomographic (CT) myelography are usually recommended.

If a patient has bladder problems and seeks medical help from an urologist, there are tests that can help diagnose Tarlov cyst. The standard urological tests for Tarlov cyst help determine if the patient has a neurogenic (malfunctioning) bladder. In urodynamics, the bladder is filled with water through a catheter and the responses are noted. Cystoscopy involves inserting a tube with a miniature video camera into the bladder via the urethra. A neurogenic bladder shows excessive muscularity. A third possible test is a kidney ultrasound to see if urine is backing up into the kidneys.

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