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Die Wirbelsäule 2021; 05(02): 79-84
DOI: 10.1055/a-1291-8854
Übersicht

Sakrale Wurzeltaschenzysten - Epidemiologie, Diagnostik und Therapie

Sacral Perineural Cysts – Epidemiology, Diagnostics, and Therapy
Axel Neulen
1   Neurochirurgische Klinik und Poliklinik, Universitätsmedizin Mainz, Mainz
,
Max Jägersberg
1   Neurochirurgische Klinik und Poliklinik, Universitätsmedizin Mainz, Mainz
,
Carolin Brockmann
2   Klinik und Poliklinik für Neuroradiologie, Universitätsmedizin Mainz, Mainz
,
Florian Ringel
1   Neurochirurgische Klinik und Poliklinik, Universitätsmedizin Mainz, Mainz
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Zusammenfassung

Sakrale Wurzeltaschenzysten (Tarlov Zysten) sind Zysten, die von den sakralen Nervenwurzeln ausgehen. Sie stellen in der wirbelsäulenchirurgischen Sprechstunde ein eher seltenes Krankheitsbild dar. Allerdings berichten radiologische Studien von einer relativ hohen Prävalenz von bis zu 8,9%, wobei nur ein sehr kleiner Teil der Zysten symptomatisch wird. Die Symptome können sich einerseits in mono- oder polyradikulären Beschwerden wie Ischialgien, sensiblen Defiziten, Paresen oder Blasen-/Mastdarmstörungen äußern, andererseits in Schmerzen wie tief sitzenden Lumbalgien, sakralen Schmerzen, einer Coccygodynie oder auch abdominellen Schmerzen. Die Diagnose einer Wurzeltaschenzyste wird in der Schnittbildgebung gestellt, meist in der Magnetresonanztomographie. Eine Myelographie erlaubt die Differenzierung zwischen Zysten mit und ohne freier Kommunikation mit dem Liquorraum. Bei persistierenden der Zyste zuzuordnenden Beschwerden stehen operative wie auch interventionelle Verfahren zur Verfügung.

Abstract

Sacral perineural cysts (Tarlov cysts) are cysts of the sacral nerve roots. They present a rare clinical entity in spine surgery. However, imaging studies report a rather high prevalence of up to 8.9%, while only a small part of the cysts will become symptomatic. Symptoms range from mono- or polyradicular complaints such as sciatic pain, sensory deficits, paresis, and vesicorectal dysfunction to lumbar, sacral, coccygeal or abdominal pain. The diagnosis is made by cross-sectional imaging, in most cases by magnetic resonance imaging. Myelography allows differentiation between cysts with and cysts without free communication with the subarachnoid space. Surgical and interventional techniques are available in case of persisting complaints related to a Tarlov cyst.



Publication History

Article published online:
29 April 2021

© 2021. Thieme. All rights reserved.

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