Tarlov cysts are sacs filled with cerebrospinal fluid that most often affect nerve roots in the sacrum, the group of bones at the base of the spine.
Women are at much higher risk of developing these cysts than are men.
These cysts (also known as meningeal or perineural cysts) can compress nerve roots, causing:
- Lower back pain
- Sciatica – shock-like or burning pain in the lower back, buttocks, and down one leg to below the knee
- Urinary incontinence
- Headaches – due to changes in cerebrospinal fluid pressure
- Sexual dysfunction
- Some loss of feeling or control of movement in the leg and/or foot
Pressure on the nerves next to the cysts can also cause pain and deterioration of surrounding bone.
Tarlov cysts can be diagnosed using magnetic resonance imaging (MRI); however, it is estimated that 70% of the cysts observed by MRI cause no symptoms. Tarlov cysts may become symptomatic following shock, trauma, or exertion that causes the buildup of cerebrospinal fluid. Some scientists believe the herpes simplex virus, which thrives in an alkaline environment, can also cause Tarlov cysts to become symptomatic.
Most Tarlov cysts do not cause pain, weakness, or nerve root compression. Acute and chronic pain may require changes in lifestyle. If left untreated, nerve root compression can cause permanent neurological damage.
Tarlov cysts may be drained and shunted to relieve pressure and pain, but relief is often only temporary and fluid build-up in the cysts will recur. Corticosteroid injections may also temporarily relieve pain. Other drugs may be prescribed to treat chronic pain and depression. Injecting the cysts with fibrin glue (a combination of naturally occurring substances based on the clotting factor in blood) may provide temporary relief of pain. Making the body less alkaline, through diet or supplements, may lessen symptoms. Microsurgical removal of the cyst may be an option in select individuals who do not respond to conservative treatments and who continue to experience pain or progressive neurological damage.