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Tarlov Cyst

(Perineural Cyst; Sacral Nerve Root Cyst)

by Cynthia M. Johnson, MA

Definition

Tarlov cysts are abnormal sacs of spinal fluid that usually form around spinal root nerve fibers at the lower end (sacrum) of the spine.

Sacrum

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Causes

The exact cause is not known. It may be due to problems with how a person's nerve sheath develops.

Risk Factors

This problem is more common in women. It may also be more common in people who have connective tissue disorders, such as systemic lupus erythematosus and Marfan syndrome.

Symptoms

Most people do not have symptoms. Some people may only have symptoms after an event that causes it to become painful, such as trauma or childbirth.

Problems may be:

  • Pain in the lower back, buttocks, legs and feet, vagina, rectum, or abdomen
  • Pain that runs down one or both legs
  • Weakness, cramping, or numbness in the buttocks, legs, and feet
  • Pain when sitting or standing
  • Loss of feeling on the skin
  • Poor reflexes
  • Bladder or bowel problems
  • Problems with sexual function
  • Headaches

Diagnosis

You will be asked about your symptoms and health history. A physical will be done. You may need to see a doctor who treats problems with the nervous system.

Images may be taken of the spine. This can be done with:

Treatment

People who do not have symptoms may not need to be treated. The doctor will monitor the cyst for any changes.

The goal of treatment in people who do have symptoms is to ease pain. Options are:

Medications

Medicine may be given to ease nerve pain and swelling. Some options are:

  • Pain relievers taken by mouth or applied to the skin
  • Corticosteroid or other medicated injections

Other Procedures

People who are not helped by medicine may need procedures to treat the cyst. Options are:

  • Transcutaneous electrical nerve stimulation (TENS)—electrical impulses delivered through the skin to ease nerve pain
  • Aspiration of the cyst plus fibrin glue injection—a needle is used to drain the cyst and then a special glue is injected into the cyst to try to prevent it from filling again

People with severe symptoms or those who are not helped by other methods may need surgery to remove the cyst.

Prevention

There are no current guidelines to prevent this health problem.

RESOURCES:

National Institute of Neurological Disorders and Stroke
https://www.ninds.nih.gov
Tarlov Cyst Disease Foundation
https://www.tarlovcystfoundation.org

CANADIAN RESOURCES:

Alberta Health
http://www.health.alberta.ca
HealthLink BC
https://www.healthlinkbc.ca

References:

Tarlov cyst information. Tarlov Cyst Disease Foundation website. Available at: https://www.tarlovcystfoundation.org/info. Accessed September 16, 2021.
Tarlov cysts. NORD—National Organization for Rare Disorders website. Available at: https://rarediseases.org/rare-diseases/tarlov-cysts. Accessed September 16, 2021.
Tarlov cysts. GARD—Genetic and Rare Diseases Information Center website. Available at: https://rarediseases.info.nih.gov/diseases/9258/tarlov-cysts/cases/27316. Accessed September 16, 2021.
Last reviewed July 2021 by EBSCO Medical Review Board Mary-Beth Seymour, RN
Last Updated: 9/16/2021