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Tarlov cysts: an overlooked clinical problem.
Kieran J Murphy1, David A Nussbaum, Susan Schnupp
1Medical Imaging, University of Toronto, Toronto, Ontario, Canada. Kieran.Murphy@uhn.on.ca
Seminars in Musculoskeletal Radiology
|April 19, 2011
Summary
Symptomatic Tarlov cysts cause chronic pain. CT-guided needle aspiration with fibrin injection offers a safe and effective first-line treatment, avoiding complications seen with other methods.
Area of Science:
- Neurosurgery
- Radiology
- Pain Management
Background:
- Symptomatic Tarlov cysts cause chronic pelvic and lower extremity pain, often leading to sacral nerve root issues.
- Traditional open surgery for Tarlov cysts has high morbidity, including cerebrospinal fluid (CSF) leaks and infections, often requiring repeat surgeries.
- Previous CT-guided aspirations showed limited efficacy and safety, with unexplained aseptic meningitis.
Purpose of the Study:
- To evaluate the efficacy and safety of CT fluoroscopic-guided needle aspiration and fibrin injection for symptomatic Tarlov cysts.
- To establish this procedure as a viable first-line treatment option.
Main Methods:
- Over 100 patients with symptomatic Tarlov cysts were treated.
- Procedures involved CT fluoroscopic-guided needle aspiration followed by fibrin injection.
Main Results:
- Excellent results were achieved in treating over 100 patients.
- No meaningful complications were observed.
- Aseptic meningitis was not reported in any cases.
Conclusions:
- CT fluoroscopic-guided needle aspiration and fibrin injection is a safe and highly effective treatment for symptomatic Tarlov cysts.
- This minimally invasive approach offers superior outcomes compared to historical surgical methods and previous aspiration techniques.
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