Tarlov cysts are sacs or lesions in the spine in the tailbone or sacral region. The sacral region consists of five sacral vertebrae at the base of the spine right above the tailbone. Spinal fluid fills up the cysts, which can vary in size. Smaller cysts may go undetected, while larger cysts tend to cause more symptoms. Cysts often start small and grow larger and more problematic as the sac fills with spinal fluid. Unlike other cysts that can form in the spine, Tarlov cysts contain nerve fibers within the cyst walls. Its positioning around a nerve root earns it alternative names of perineural or sacral nerve root cyst.
As fluid fills the cysts, the expanding size causes pressure and may compress nerve roots, which can cause a host of symptoms and side effects. The pressure can also cause deterioration of the bones in the area. The condition is very rare.
The symptoms of Tarlov cysts vary significantly depending on the severity of the cyst. In some cases, a Tarlov cyst doesn’t produce any noticeable symptoms. These minor cases may go undetected. As the cysts grow and expand, they press on the nerve roots, which often causes symptoms to appear. You might first feel pressure and then eventually pain. The symptoms you feel may also vary depending on the exact location of the cyst.
Patients have expressed common symptoms, such as:Back and perineal pain，Urinary incontinence，Sciatica，Dysuria，Radicular pain，Headaches，Retrograde ejaculation，Parasthesia, or abnormal sensations in the extremities，Hypesthesia，Difficulty walking，Severe lower abdominal pain，Interstitial cystitis，Weakness in the extremities，Swelling in the sacral area，Soreness or tenderness in the area，Headaches resulting from changes in spinal fluid pressure，Dizziness or balance issues，Restless leg syndrome，Sexual dysfunction
Diagnosis of a Tarlov cyst often happens once the symptoms occur. The doctor may perform a physical exam first. An MRI is an effective way to determine if the source of pain is a Tarlov cyst. The cyst looks like a dilated area or a balloon-like structure in the sacral area of the spinal column.
Traditional Treatments ：
Because of the still unclear pathogenesis of Tarlov Cysts, there has yet to be a consensus on their optimal treatment. Treatment is handled on a case-by-case basis depending on the specific symptoms, cyst location and severity of the case. The medical care team treats the specific symptoms and effects of the cyst to provide as much relief as possible while preventing damage to the spinal cord. In minor cases with few or no symptoms, the patient may receive no treatment at all.
Surgery is an option for some patients if the cysts do cause serious pain or other complications. This typically happens when the cysts grow in size and cause significant compression in the spinal cord. Two commonly utilized surgical procedures include the draining and extraction of cerebrospinal fluids from the cyst and the complete or partial removal of the cyst from the area.
If the decision is made to drain the cyst, the procedure can provide relief right away from the pain and pressure. However, the effects are not usually long-lasting. The fluid often begins filling the cyst again after the draining procedure. This can cause the pain and pressure to return.