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Archives of Sexual Behavior Apr 2024Tarlov cysts adjacent to the spinal cord are usually asymptomatic and found incidentally via magnetic resonance imaging. On rare occasions, they increase in size to...
Tarlov cysts adjacent to the spinal cord are usually asymptomatic and found incidentally via magnetic resonance imaging. On rare occasions, they increase in size to produce symptoms resembling disk herniation. We report a rare case of a sacral cyst resulting in premature ejaculation in a 32-year-old man who presented with pelvic pain and acquired premature ejaculation. Spinal nerve root decompression, excision of intraspinal Tarlov cyst, and spinal nerve root adhesion release surgery significantly improved his pain and premature ejaculation at a six-month follow-up.
Topics: Male; Humans; Adult; Tarlov Cysts; Premature Ejaculation; Pelvic Pain; Magnetic Resonance Imaging
PubMed: 38366312
DOI: 10.1007/s10508-024-02815-7 -
Global Spine Journal Dec 2023A register-based retrospective series and a systematic review of literature.
STUDY DESIGN
A register-based retrospective series and a systematic review of literature.
OBJECTIVES
Tarlov cysts are meningeal cysts typically found in the sacral region. They have a dualistic nature ranging from an incidental finding to a symptomatic pathology. There are no established treatment protocols and predictors of operative outcome. Therefore, we aimed to study the outcome of surgical treatment for Tarlov cysts and to characterize patient-, and treatment-related factors predicting outcomes.
METHODS
A systematic review of previous literature was performed and a retrospective cohort of all patients operated on for Tarlov cysts at BLINDED between 1995 and 2020 was collected. Patient records were evaluated along with radiological images.
RESULTS
Ninety-seven consecutive patients were identified with follow-up data available for 96. Improvement of symptoms after surgery was observed in 76.0% of patients (excellent or good patient-reported outcome) and the complication rate was 17.5%. Sacral or lower back pain as a preoperative symptom was associated with improvement after surgery ( = .007), whereas previous lower back surgery was more common in patients who did not benefit from surgery ( = .034). No independent predictors of outcome were identified in a regression analysis.
CONCLUSIONS
This is the second-largest study on the treatment of Tarlov cysts ever published. Operative treatment in a selected patient population will likely produce improvement in the symptoms when balanced with the complication rate and profile of surgery. Preoperative lower back or sacral pain is a potential indicator for improvement after surgery.
PubMed: 38069780
DOI: 10.1177/21925682231221538 -
Neuroradiology Jan 2024Tarlov cysts were thought to be anatomic variants of uncertain etiology and clinical significance when initially described over 80 years ago. They are often detected in... (Review)
Review
Tarlov cysts were thought to be anatomic variants of uncertain etiology and clinical significance when initially described over 80 years ago. They are often detected in routine lumbosacral imaging and generally not reported in a differential diagnosis. There is increasing evidence that at least some Tarlov cysts are symptomatic and can have a significant adverse impact on patients' health and well-being. Women are disproportionately affected with this condition, often presenting with long-standing pain and neurological dysfunctions. Significant gender bias has been a concern in the management of these patients. Unfortunately, there is no consensus on patient selection or management approaches for symptomatic Tarlov cysts. This review article updates information on the prevalence, diagnosis, clinical significance, and treatments of these cysts. Based on these findings and experience with over 1000 patient referrals, a treatment decision algorithm for symptomatic Tarlov cysts was constructed to provide guidance for appropriate management of patients with these complex cysts.
Topics: Humans; Male; Female; Tarlov Cysts; Magnetic Resonance Imaging; Sexism; Spinal Diseases; Sacrum
PubMed: 37828278
DOI: 10.1007/s00234-023-03226-6 -
Journal of Medical Case Reports Dec 2023Tarlov's cyst is often underdiagnosed since it is difficult to identify without imaging assistance. Herein, we report the case of a young girl who presented with an...
BACKGROUND
Tarlov's cyst is often underdiagnosed since it is difficult to identify without imaging assistance. Herein, we report the case of a young girl who presented with an 8-year history of chronic osteomyelitis of bilateral proximal phalanges and metatarsal bones caused by a Tarlov's cyst that did not contain a nerve root. The chronic wound in the forefoot is an unusual presentation and resulted from the Tarlov's cyst accompanied with tethered conus syndrome.
CASE PRESENTATION
A 10-year-old Asian girl presented with an 8-year history of chronic osteomyelitis of bilateral proximal phalanges and metatarsal bones. She received sequestrectomy five times, however the immune function tests were all normal. A neurological examination revealed diminished sensation and a slapping gait pattern. Magnetic resonance imaging (MRI) demonstrated a lobulated cyst at the right aspect of the sacrum (S) 1 to sacrum (S) 3 canal near the dorsal root ganglion. Tethered conus syndrome was highly suspected. She received laminectomy of lumbar (L) 5 and S1-S2, which led to the diagnosis of a right S1-S3 epidural cyst. The final diagnosis from the histopathological examination was a right sacral Tarlov's cyst. The clinical conditions of diminished sensation and slapping gait pattern greatly improved after successful surgical treatment.
CONCLUSION
In children who present with a recalcitrant chronic wound in the forefoot accompanied with a slapping gait pattern and foot hypoesthesia to pain, aggressive imaging examinations such as spine MRI should be arranged for further evaluation, especially in immunocompetent children.
Topics: Female; Child; Humans; Tarlov Cysts; Cysts; Magnetic Resonance Imaging; Laminectomy; Osteomyelitis
PubMed: 38057903
DOI: 10.1186/s13256-023-04232-1 -
Frontiers in Surgery 2023Symptomatic sacral Tarlov cyst (STC) exerts a significant negative impact on the patient's quality of life, highlighting the significance of the increasing number of...
BACKGROUND
Symptomatic sacral Tarlov cyst (STC) exerts a significant negative impact on the patient's quality of life, highlighting the significance of the increasing number of studies on STC. However, bibliometric analyses in this research field are scarce. Thus, this study aims to provide a comprehensive knowledge structure and identify the research trends of STC through bibliometrics.
METHODS
Articles related to STC from 2000 to 2022 were sourced from the Web of Science Core Collection database. VOSviewer 1.6.16, CiteSpace 6.1.6, GraphPad Prism 8.2.1 and R-package "bibliometrix" were used to analyse the data and generate knowledge maps.
RESULTS
A total of 930 studies on STC from 2000 to 2022 were included. The findings revealed a consistent yet upward trend in the number of annual publications in this field. The United States, China and Turkey were the most prolific and influential countries contributing to this field, with the University of Illinois, the University of Maryland and the National Institute of Standards & Technology being the most notable research institutions. Key journals include [Impact Factor (IF) = 2.210], (IF = 4.860) and (IF = 3.467). Additionally, Tarlov Mj, Tarlov E and Zachariah Mr exhibit the highest number of publications, making them the leading authors in this field. A twenty-year retrospection of research trends using keyword analysis reveals four principal directions, namely "definition", "pathogenesis", "diagnosis" and "treatment". Currently, therapeutic surgical intervention is the key treatment for this disease, with future treatments primarily hinging on minimally invasive methodologies rooted in microendoscopic and endoscopic techniques.
CONCLUSION
This pioneering, comprehensive scientific bibliometric study provides a holistic summary of STC research trends and hot spots spanning the past 22 years. The results identify existing research frontiers and chart maps for future studies, serving as a valuable reference for scholars vested in this field.
PubMed: 38234453
DOI: 10.3389/fsurg.2023.1301739 -
Asian Journal of Surgery Dec 2023
Topics: Female; Humans; Cysts; Neck; Tarlov Cysts; Uterine Cervical Neoplasms; Middle Aged
PubMed: 37679203
DOI: 10.1016/j.asjsur.2023.08.155 -
Journal of Orthopaedic Case Reports Jun 2023Tarlov cysts are rare perineural cysts noted as an incidental finding in approximately 1% of lumbar magnetic resonance imaging (MRI) arising from extradural components...
INTRODUCTION
Tarlov cysts are rare perineural cysts noted as an incidental finding in approximately 1% of lumbar magnetic resonance imaging (MRI) arising from extradural components near the dorsal root ganglion. Due to its localization, it may cause sensory symptoms in some cases. However, most of these cysts are asymptomatic.
CASE REPORT
We present the case of a 55-year-old woman with complaints of severe pain localized to the inner aspect of the thigh and gluteal region for the past 6 months, which has not been relieved by conservative management. On examination, there was a loss of sensation around the S2 and S3 dermatome with preserved motor functions. MRI showed a cystic lesion occupying the spinal canal with a size of about 1.3 × 0.7 cm with remodeling changes around the S2 vertebra. The cyst appears hypointense on T1 and hyperintense T2-weighted images. The diagnosis of the symptomatic Tarlov cyst was made and was managed with an epidural steroid injection. The patient was relieved of symptoms and remained asymptomatic till the latest follow-up at 1 year.
CONCLUSION
Symptomatic presentation of Tarlov cyst though rare should be considered and managed appropriately if identified as the source of symptoms. Conservative management with epidural steroids is a successful method in the management of smaller cysts without motor symptoms.
PubMed: 37398541
DOI: 10.13107/jocr.2023.v13.i06.3694 -
Journal of Medical Case Reports Oct 2023Here we report the only formally documented case in the United Kingdom, to our knowledge, of a cerebral fat embolism secondary to non-iatrogenic trauma through a Tarlov...
BACKGROUND
Here we report the only formally documented case in the United Kingdom, to our knowledge, of a cerebral fat embolism secondary to non-iatrogenic trauma through a Tarlov cyst. This case demonstrates the pathology clearly giving an excellent opportunity to demonstrate a rarely seen pathology as well as illustrating the importance of the patient history to guiding further management.
CASE PRESENTATION
A middle-aged patient was admitted on the acute medical take complaining of severe headache with photophobia, having just returned after a skiing holiday. Computerised tomography scan of the head showed fat within the anterior horn of both lateral ventricles, and within the subarachnoid space. Re-discussion with the patient and subsequent MRI (Magnetic Resonance Imaging) of the spine identified the pathogenesis of her symptoms: a sacral insufficiency fracture through a Tarlov cyst, causing subarachnoid fat embolism and symptoms of a low-pressure headaches due to a dural leak. Patient was medically managed and discharged with planned follow-up. Due to the Coronavirus pandemic and resolution of the patient's symptoms, they declined further follow up imaging.
CONCLUSIONS
The case demonstrates a rarely seen pathology as cause of a common presenting problem, headache. Emphasizing the importance of history taking and appropriate investigations in medical cases that do not conform to the usual diagnosis.
Topics: Middle Aged; Female; Humans; Tarlov Cysts; Spinal Fractures; Headache Disorders; Embolism, Fat; Headache
PubMed: 37803426
DOI: 10.1186/s13256-023-04142-2 -
BMC Anesthesiology Oct 2023Cauda Equina Syndrome (CES) after Combined Spinal-Epidural Anesthesia (CSEA) is a rare disease that most of the time need surgery to relieve spinal cord compression.
BACKGROUND
Cauda Equina Syndrome (CES) after Combined Spinal-Epidural Anesthesia (CSEA) is a rare disease that most of the time need surgery to relieve spinal cord compression.
CASE PRESENTATION
A 34-year-old male patient underwent a procedure for prolapse and hemorrhoids (PPH) under CSEA. Anesthesia and surgery were uneventful. However, the patient gradually experienced urinary retention, lower abdomen and back pain, changes in bowel habits and neurological dysfunction of the lower limbs when the catheter was removed. It was later determined that the patient had Tarlov cyst at the left S1 level in the sacral canal. Finally, the patient completely recovered 20 days after drug conservative therapy onset.
CONCLUSION
This case suggests that CES might occur even after ordinary CSEA. The risk factors are drug neurotoxicity to ropivacaine and Tarlov cyst, which helped to accumulate ropivacaine. The development of ultrasound-guided CSEA and an ultrasound atlas of the spinal canal are required.
Topics: Male; Humans; Adult; Ropivacaine; Cauda Equina Syndrome; Tarlov Cysts; Anesthesia, Spinal; Anesthesia, Epidural
PubMed: 37907852
DOI: 10.1186/s12871-023-02311-w