Tarlov's cyst is usually found on an examination such as an MRI scan to assess the spine. It usually does not cause symptoms, is not serious, nor does it need surgical treatment, being totally benign and does not turn into cancer.
Tarlov's cyst is actually a small fluid-filled dilation, located in the sacrum, between the vertebrae S1, S2 and S3, more specifically in the nerve roots of the spine, in the tissues that line the spinal cord.
The individual may have only 1 cyst or several, and depending on its location it can be bilateral and when they are very large they can compress the nerves, causing nervous changes, such as tingling or shock, for example.
Symptoms of Tarlov's cyst
In about 80% of cases, the Tarlov cyst has no symptoms, but when this cyst has symptoms, they can be:
- Leg pain; Difficulty walking; Back pain at the end of the spine; Tingling or feeling of numbness at the end of the spine and legs; Decreased sensitivity in the affected area or legs; There may be changes in the sphincter, with risk of loss of feces.
The most common is only back pain, with suspected herniated disc, and then the doctor orders the MRI and discovers the cyst. These symptoms are related to the compression that the cyst makes on the nerve roots and bone parts of that region.
Other changes that can present these symptoms are inflammation of the sciatic nerve and herniated disc. Learn how to fight sciatica.
The causes of its appearance are not fully known, but it is believed that Tarlov's cyst may be congenital or related to some local trauma or subarachnoid hemorrhage, for example.
Necessary exams
Typically, Tarlov's cyst is seen on an MRI scan, but a simple X-ray can also be useful to assess the presence of osteophytes. In addition, it is also important to assess the presence of other situations such as herniated discs or spondylolisthesis, for example.
The orthopedist may request other tests such as computed tomography to assess the impact of this cyst on the bones around him, and electroneuromyography may be requested to assess the suffering of the nerve root, showing the need for surgery. But both CT and electroneuromyography are only requested when the person has symptoms.
Treatment for Tarlov cyst
The treatment that may be advised by the doctor includes taking painkillers, muscle relaxants, antidepressants or epidural analgesia which may be sufficient to control the symptoms.
However, physiotherapy is especially indicated to combat symptoms and improve the person's quality of life. Physical therapy treatment should be performed daily using devices that relieve pain, heat and stretches for the back and legs. Articular and neural mobilization can also be useful in some cases, but each case must be evaluated by the physical therapist personally, because the treatment must be individualized.
Here are some exercises that, in addition to being indicated for sciatica, can also be indicated to relieve back pain caused by Tarlov's cyst:
When to have surgery
The person who has symptoms and does not improve with medication and physiotherapy can choose surgery as a way to solve their symptoms.
However, surgery is rarely indicated but can be done to remove the cyst through a laminectomy or puncture to empty the cyst. It is usually indicated for cysts over 1.5 cm with bone changes around them.
Normally, the person cannot retire if only this cyst is present, but he may be unable to work if he presents in addition to the cyst, other important changes that prevent or hinder work activity.
