Symptomatic Tarlov cysts: A case series and effectiveness of multimodal rehabilitation plus pharmacological treatment
Tarlov cysts, or perineural cysts, are nerve root lesions most frequently found in the sacral region.1 They were first described by Tarlov in 1938, during an autopsy study of the filum terminale. Since then, at least 100 symptomatic cases have been reported, although very few describe faecal incontinence (< 3%), pelvic pain, or urinary incontinence.2
Tarlov cysts are extremely rare, with greater incidence among women aged 30–50 years; the most frequent symptoms are pain and radiculopathy. They are most frequently located in the sacral region. Less frequently, these cysts may cause bowel and bladder dysfunction, leading to urinary or faecal incontinence.1,2
The incidence of Tarlov cysts in the general population is 1%, increasing to 4.6% in magnetic resonance imaging (MRI) studies of patients with lower back pain; the lumbar and especially the sacral spine are the most frequently affected regions. Cysts are usually asymptomatic, requiring no treatment.3