Tarlov Cyst Is Correlated with a Short Broad Terminal of the Thecal Sac

Abstract

Background In clinical practice, we noted that the end section of the thecal sac is apparently different in patients with Tarlov cyst compared with that of the normal population. We conducted this clinical study based on magnetic resonance imaging (MRI).

Methods Our study included 30 patients with Tarlov cyst and 30 healthy volunteers as the control. The L4, L5 cross-section areas, the L4, L5 anteroposterior diameters, and the terminal length of the thecal sac were measured from the lumbosacral spine MRI.

Results The L4, L5 cross-section areas and the L4, L5 anteroposterior diameters are larger for the Tarlov cyst patients than the controls, but the terminal length of the thecal sac is shorter.

Conclusion The Tarlov cyst is correlated with a short broad end of the thecal sac. Possibly, this anatomical variant is a causative factor of Tarlov cyst.

Keywords

Tarlov cyst - etiology - thecal sac

• References

• 1 Caspar W, Papavero L, Nabhan A, Loew C, Ahlhelm F. Microsurgical excision of symptomatic sacral perineurial cysts: a study of 15 cases. Surg Neurol 2003; 59 (2) 101-105 ; discussion 105–106
• 2 Lucantoni C, Than KD, Wang AC , et al. Tarlov cysts: a controversial lesion of the sacral spine. Neurosurg Focus 2011; 31 (6) E14
• 3 Nadler SF, Bartoli LM, Stitik TP, Chen B. Tarlov cyst as a rare cause of S1 radiculopathy: a case report. Arch Phys Med Rehabil 2001; 82 (5) 689-690
• 4 Yucesoy K, Ozer E, Koyuncuoglu M, Alici E. Filling of a sacral bone defect from a perineurial cyst by cementation. J Spinal Disord Tech 2002; 15 (6) 523-525
• 5 Cantore G, Bistazzoni S, Esposito V , et al. Sacral Tarlov cyst: surgical treatment by clipping. World Neurosurg 2013; 79 (2) 381-389
• 6 Singh PK, Singh VK, Azam A, Gupta S. Tarlov cyst and infertility. J Spinal Cord Med 2009; 32 (2) 191-197
• 7 Neulen A, Kantelhardt SR, Pilgram-Pastor SM, Metz I, Rohde V, Giese A. Microsurgical fenestration of perineural cysts to the thecal sac at the level of the distal dural sleeve. Acta Neurochir (Wien) 2011; 153 (7) 1427-1434 ; discussion 1434
• 8 Freidenstein J, Aldrete JA, Ness T. Minimally invasive interventional therapy for Tarlov cysts causing symptoms of interstitial cystitis. Pain Physician 2012; 15 (2) 141-146
• 9 Lee JY, Impekoven P, Stenzel W, Löhr M, Ernestus RI, Klug N. CT-guided percutaneous aspiration of Tarlov cyst as a useful diagnostic procedure prior to operative intervention. Acta Neurochir (Wien) 2004; 146 (7) 667-670
• 10 Prashad B, Jain AK, Dhammi IK. Tarlov cyst: Case report and review of literature. Indian J Orthop 2007; 41 (4) 401-403
• 11 Dimitroulias AP, Stenner RC, Cavanagh PM, Madhavan P, Webb PJ. Multiple bilateral sacral perineural cysts unusually distal to the exit foramina. Br J Neurosurg 2007; 21 (5) 521-522
• 12 Park HJ, Kim IS, Lee SW, Son BC. Two cases of symptomatic perineural cysts (Tarlov cysts) in one family: a case report. J Korean Neurosurg Soc 2008; 44 (3) 174-177
• 13 Xu J, Sun Y, Huang X, Luan W. Management of symptomatic sacral perineural cysts. PLoS One 2012; 7 (6) e39958
• 14 Jung KT, Lee HY, Lim KJ. Clinical experience of symptomatic sacral perineural cyst. Korean J Pain 2012; 25 (3) 191-194
• 15 Kim K, Chun SW, Chung SG. A case of symptomatic cervical perineural (Tarlov) cyst: clinical manifestation and management. Skeletal Radiol 2012; 41 (1) 97-101
• 16 Smith ZA, Fessler RG, Batjer HH. Perspective—sacral Tarlov cyst: surgical treatment by clipping. World Neurosurg 2013; 79 (2) 285
• 17 Murphy KJ, Nussbaum DA, Schnupp S, Long D. Tarlov cysts: an overlooked clinical problem. Semin Musculoskelet Radiol 2011; 15 (2) 163-167
• 18 Smith ZA, Li Z, Raphael D, Khoo LT. Sacral laminoplasty and cystic fenestration in the treatment of symptomatic sacral perineural (Tarlov) cysts: technical case report. Surg Neurol Int 2011; 2: 129
• 19 Murphy K, Wyse G, Schnupp S , et al. Two-needle technique for the treatment of symptomatic Tarlov cysts. J Vasc Interv Radiol 2008; 19 (5) 771-773
• 20 H'ng MW, Wanigasiri UI, Ong CL. Perineural (Tarlov) cysts mimicking adnexal masses: a report of three cases. Ultrasound Obstet Gynecol 2009; 34 (2) 230-233
• 21 Asamoto S, Fukui Y, Nishiyama M , et al. Diagnosis and surgical strategy for sacral meningeal cysts with check-valve mechanism: technical note. Acta Neurochir (Wien) 2013; 155 (2) 309-313
• 22 Guest JD, Silbert L, Casas CE. Use of percutaneous endoscopy to place syringopleural or cystoperitoneal cerebrospinal fluid shunts: technical note. J Neurosurg Spine 2005; 2 (4) 498-504
• 23 Tanaka M, Nakahara S, Ito Y , et al. Surgical results of sacral perineural (Tarlov) cysts. Acta Med Okayama 2006; 60 (1) 65-70
• 24 Tsutsumi S, Wachi A, Uto A, Koike J, Arai H, Sato K. Infantile arachnoid cyst compressing the sacral nerve root associated with spina bifida and lipoma—case report. Neurol Med Chir (Tokyo) 2000; 40 (8) 435-438
• 25 Uemura K, Komatsu Y, Shibata T, Kobayashi E, Nose T. Sacral meningeal cyst associated with valve-like mechanism—case report. Neurol Med Chir (Tokyo) 2001; 41 (5) 288-291
• 26 Manara R, Severino M, Mandari R, Mattisi G, Dal Pozzo S, Carollo C. Chronic cystic lesion of the sacrum: characterisation with diffusion-weighted MR imaging. Radiol Med (Torino) 2008; 113 (5) 739-746