Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2015 Jul-Sep;10(3):222-5.
doi: 10.4103/1793-5482.161177.

Symptomatic lumbosacral perineural cysts: A report of three cases and review of literature

Mayur Sharma  1 , Vernon Velho  1 , Rahul Mally  1 , Shadma W Khan  1
Affiliations
Case Reports

Symptomatic lumbosacral perineural cysts: A report of three cases and review of literature

Mayur Sharma et al. Asian J Neurosurg. 2015 Jul-Sep.

Abstract

Lumbosacral perineural cysts (Tarlov's cysts) are nerve root cysts, which are usually asymptomatic and are detected incidentally on imaging. These cysts are rare with an incidence of 4.6%. We report three cases of Lumbosacral Tarlov's cysts, which presented with cauda equina syndrome and radicular pain syndrome. Two of our patients had symptoms of cauda equina syndrome, and one had acute sciatica. Complete excision of the cyst was achieved in two patients and marsupialization of the cyst was done in another patient due to its large size and dense adherence to the sacral nerve roots. All the patients were relieved of the radicular pain with no new neurological deficit following surgery. Symptomatic lumbosacral Tarlov's cyst is a rare lesion, and the presentation can be low back pain, cauda equina syndrome or sciatica. Therefore, this entity should be kept in the differential diagnosis of patients presenting with these symptoms. Complete Surgical excision of these symptomatic cysts is the treatment of choice to achieve a cure.

Keywords: cyst; lumbosacral; perineural; symptomatic.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Magnetic resonance imaging scan (T2-weighted sequence, sagittal view) of the lumbosacral spine showing a well-defined cystic lesion along the traversing left L4 nerve root suggestive of perineural cyst
Figure 2
Figure 2
Magnetic resonance imaging scan (T2-weighted sequence, sagittal view) of the lumbosacral spine showing an intraspinal meningeal cyst extending from L5 to S4, extending into right neural foramina from L5 to S3 and left neural foramina from S1 to S3 with pressure erosion of the surrounding bone
Figure 3
Figure 3
Magnetic resonance imaging scan (T2 weighted sequence, axial view) of the lumbosacral spine showing a well-defined cystic lesion along the traversing left L5-S1 nerve root suggestive of perineural cyst
Figure 4
Figure 4
Histopathological examination showing the fibrocollagenous tissue intermingled with the nerve fascicles. Occasional mononuclear infiltration can also be seen
See this image and copyright information in PMC

References

    1. Langdown AJ, Grundy JR, Birch NC. The clinical relevance of Tarlov cysts. J Spinal Disord Tech. 2005;18:29–33. - PubMed
    1. Tarlov IM. Spinal perineurial and meningeal cysts. J Neurol Neurosurg Psychiatry. 1970;33:833–43. - PMC - PubMed
    1. Paulsen RD, Call GA, Murtagh FR. Prevalence and percutaneous drainage of cysts of the sacral nerve root sheath (Tarlov cysts) AJNR Am J Neuroradiol. 1994;15:293–7. - PMC - PubMed
    1. Caspar W, Papavero L, Nabhan A, Loew C, Ahlhelm F. Microsurgical excision of symptomatic sacral perineurial cysts: A study of 15 cases. Surg Neurol. 2003;59:101–5. - PubMed
    1. Taveras JM, Wood EH. 2nd ed. Vol. 2. Baltimore: Williams and Wilkins; 1976. Diagnostic Neuroradiology; pp. 1139–45.

Publication types