(Perineural Cyst; Sacral Nerve Root Cyst)
Tarlov cysts are abnormal sacs of spinal fluid that often form around spinal root nerve fibers at the lower end (sacrum) of the spine.
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The exact cause is not known. It may be due to problems with how a person's nerve sheath forms.
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, feet, vagina, rectum, belly, or 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
The doctor will ask about symptoms and health history. A physical exam will be done. A doctor who treats problems with the nervous system may need to be seen.
Images may be taken of the spine. This can be done with:
People who do not have symptoms may not need to be treated. The doctor will check the cyst for any changes.
The goal of treatment in people who do have symptoms is to ease pain. Options are:
There are no current guidelines to prevent this health problem.
Medicine may be given to ease nerve pain and swelling. Some options are:
- Pain relievers taken by mouth or put on the skin
- Corticosteroid or other medicated injections
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 stop it from filling again
People with severe symptoms or those who are not helped by other methods may need surgery to remove the cyst.
- Chronic low back pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/chronic-low-back-pain.
- Tarlov cyst information. Tarlov Cyst Disease Foundation website. Available at: https://www.tarlovcystfoundation.org/info.
- Tarlov cysts. NORD—National Organization for Rare Disorders website. Available at: https://rarediseases.org/rare-diseases/tarlov-cysts.
- Mary-Beth Seymour, RN
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