A Tarlov cyst is a fluid-filled nerve root sac often found along the vertebrae at the base of the spine. Oftentimes they occur along the posterior nerve root, and they are somewhat common. About 5 to 10 percent of the general population have small, asymptomatic Tarlov cysts in their lower back. Larger, pain-inducing cysts are much more rare, and they can be difficult to diagnose as they are often mistaken for herniated discs or arachnoiditis. One of the features that distinguishes Tarlov cysts from other spinal lesions is the presence of spinal nerve roots inside the cyst wall or the cyst cavity.

Tarlov Cyst Causes & Symptoms

Although the exact cause of Tarlov Cysts is unknown, many medical experts believe trauma causes asymptomatic Tarlov cysts to become symptomatic. There have been documented incidents of car crashes and other trauma to the lumbar spine causing asymptomatic Tarlov cysts to flare up. Sometimes they can also be caused by structural changes in the body, and pregnancy also appears to be another reason someone develops a Tarlov cyst. Because of this, Tarlov cysts are far more common in women.

Symptoms of a Tarlov cyst in the lower spine include:

• Pain in the affected region
• Leg or muscle weakness
• Difficulty standing
• Delayed reflexes
• Changes in bowel, bladder or sexual function

Diagnosis & Treatment of Tarlov Cysts

As we mentioned above, Tarlov cysts are rather rare, so they are often overlooked by primary care physicians. That’s why it’s important to visit a spine specialist if back pain persists. If your back specialist suspects a Tarlov cyst is causing your pain, he or she will likely order an MRI or a CT scan.

Once the spine specialist has diagnosed you with a Tarlov cyst, they’ll walk you through your non-surgical and surgical options. Non-surgical treatment includes drainage of the cerebrospinal fluid or CT guided cyst aspiration to relieve pressure caused by the cyst. Although this has been shown to be effective in the short-term, symptoms will likely eventually return.

One surgical option for Tarlov cysts involves exposing the cyst, draining the fluid and then injecting the cysts with a substance to prevent fluid from returning. Other options include decompressive laminectomy, cyst/nerve root excision and microsurgical cyst fenestration and imbrication.

If you are suffering from any of the above symptoms and believe you may be dealing with a Tarlov cyst, contact a skilled spinal specialist today.

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