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Microsurgical treatment of sacral perineural (Tarlov) cysts: case series and review of the literature.

Publication ,  Journal Article
Burke, JF; Thawani, JP; Berger, I; Nayak, NR; Stephen, JH; Farkas, T; Aschyan, HJ; Pierce, J; Kanchwala, S; Long, DM; Welch, WC
Published in: Journal of neurosurgery. Spine
May 2016

OBJECTIVE Tarlov cysts (TCs) occur most commonly on extradural components of the sacral and coccygeal nerve roots. These lesions are often found incidentally, with an estimated prevalence of 4%-9%. Given the low estimated rates of symptomatic TC and the fact that symptoms can overlap with other common causes of low-back pain, optimal management of this entity is a matter of ongoing debate. Here, the authors investigate the effects of surgical intervention on symptomatic TCs and aim to solidify the surgical criteria for this disease process. METHODS The authors performed a retrospective review of data from consecutive patients who were surgically treated for symptomatic TCs from September 2011 to March 2013. Clinical evaluations and results from surveying pain and overall health were used. Univariate statistical analyses were performed. RESULTS Twenty-three adults (4 males, 19 females) who had been symptomatic for a mean of 47.4 months were treated with laminectomy, microsurgical exposure and/or imbrication, and paraspinous muscle flap closure. Eighteen patients (78.3%) had undergone prior interventions without sustained improvement. Thirteen patients (56.5%) underwent lumbar drainage for an average of 8.7 days following surgery. The mean follow-up was 14.4 months. Univariate analyses demonstrated that an advanced age (p = 0.045), the number of noted perineural cysts on preoperative imaging (p = 0.02), and the duration of preoperative symptoms (p = 0.03) were associated with a poor postoperative outcome. Although 47.8% of the patients were able to return to normal activities, 93.8% of those surveyed reported that they would undergo the operation again if given the choice. CONCLUSIONS This is one of the largest published studies on patients with TCs treated microsurgically. The data suggest that patients with symptomatic TCs may benefit from open microsurgical treatment. Although outcomes seem related to patient age, duration of symptoms, and extent of disease demonstrated on imaging, further study is warranted and underway.

Duke Scholars

Published In

Journal of neurosurgery. Spine

DOI

EISSN

1547-5646

ISSN

1547-5654

Publication Date

May 2016

Volume

24

Issue

5

Start / End Page

700 / 707

Related Subject Headings

  • Treatment Outcome
  • Tarlov Cysts
  • Retrospective Studies
  • Paraspinal Muscles
  • Orthopedics
  • Middle Aged
  • Microsurgery
  • Male
  • Magnetic Resonance Imaging
  • Lumbosacral Region
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Burke, J. F., Thawani, J. P., Berger, I., Nayak, N. R., Stephen, J. H., Farkas, T., … Welch, W. C. (2016). Microsurgical treatment of sacral perineural (Tarlov) cysts: case series and review of the literature. Journal of Neurosurgery. Spine, 24(5), 700–707. https://doi.org/10.3171/2015.9.spine153
Burke, John F., Jayesh P. Thawani, Ian Berger, Nikhil R. Nayak, James H. Stephen, Tunde Farkas, Hovik John Aschyan, et al. “Microsurgical treatment of sacral perineural (Tarlov) cysts: case series and review of the literature.Journal of Neurosurgery. Spine 24, no. 5 (May 2016): 700–707. https://doi.org/10.3171/2015.9.spine153.
Burke JF, Thawani JP, Berger I, Nayak NR, Stephen JH, Farkas T, et al. Microsurgical treatment of sacral perineural (Tarlov) cysts: case series and review of the literature. Journal of neurosurgery Spine. 2016 May;24(5):700–7.
Burke, John F., et al. “Microsurgical treatment of sacral perineural (Tarlov) cysts: case series and review of the literature.Journal of Neurosurgery. Spine, vol. 24, no. 5, May 2016, pp. 700–07. Epmc, doi:10.3171/2015.9.spine153.
Burke JF, Thawani JP, Berger I, Nayak NR, Stephen JH, Farkas T, Aschyan HJ, Pierce J, Kanchwala S, Long DM, Welch WC. Microsurgical treatment of sacral perineural (Tarlov) cysts: case series and review of the literature. Journal of neurosurgery Spine. 2016 May;24(5):700–707.

Published In

Journal of neurosurgery. Spine

DOI

EISSN

1547-5646

ISSN

1547-5654

Publication Date

May 2016

Volume

24

Issue

5

Start / End Page

700 / 707

Related Subject Headings

  • Treatment Outcome
  • Tarlov Cysts
  • Retrospective Studies
  • Paraspinal Muscles
  • Orthopedics
  • Middle Aged
  • Microsurgery
  • Male
  • Magnetic Resonance Imaging
  • Lumbosacral Region