A novel surgical technique for treatment of symptomatic Tarlov cysts

Abstract

Background

The aim of this retrospective study was to describe a novel, simple surgical technique for the treatment of symptomatic Tarlov cysts.

Methods

A total of 40 patients with symptomatic Tarlov cysts, admitted to our tertiary center between 1998 and 2019 constituted the study group. All patients underwent microsurgical puckering of the cyst, the technique we described to prevent a recurrence. Patients’ symptoms, radiological findings, intraoperative findings, and clinical results were evaluated.

Results

Of the 40 patients (5 males, 35 females) whose charts were reviewed, the mean age was 28.4 (range, 17–61) years. The mean follow-up was 8 (range, 3 months to 21 years) years. Preoperatively, the most common symptoms were leg pain and numbness of the lower extremity. Postoperatively, no major complications were observed. Clinical progression was halted in all patients; 33 (82%) patients recovered completely and seven (17%) patients reported partial recovery. Cystic cavity persisted radiologically in five (12%) patients, decreased in size in 30 (75%) patients, and regressed completely in the remaining five (12%) patients. None of the patients had permanent neurological deficits.

Conclusion

Puckering of the cyst membrane is a safe and easy-to-perform surgical technique for symptomatic Tarlov cysts. This technique can be used almost in all cases instead of the commonly used microsurgical cyst excision or cyst fenestration.

Keywords:

• Tarlov cyst
• perineural cyst
• microsurgical treatment pain
• recurrence

Ethical approval

This study has been approved by the local institutional review board (2020/15-54). Written informed consent from all participants had been obtained for use of data. Strict adherence to principles announced in the Declaration of Helsinki was provided.

Disclosure statement

The authors declare no competing interests.

Data availability statement

Datasets and related files are available and can be shared upon request. Codes for a software application or custom code are available and can be shared upon request.