Whitesburg KY

Tarlov cysts and back pain



DEAR DR. ROACH: I was a healthy female until I had an injury to my back. I experience pain and tingling in my right side, going down the back of my right leg. Sitting is especially painful, as is standing in one place for too long.

Now the pain has started in my left side also. I have tried chiropractors, acupuncture, physical therapy, epidural shots and pain pills. I also had two laminectomies (decompression surgery on the spinal canal) on L4/L5 last year, with no relief from the pain. Upon seeing another neurosurgeon, I have been told that I have some large Tarlov cysts (1 cm).

There does not seem to be a great amount of information about these on the internet, plus I am not sure what information out there is accurate. One doctor on the internet is all about having surgery on them. The neurosurgeon I am seeing does not want to do surgery just yet. He says that surgery does not always bring about pain relief.

Can you share some information about these Tarlov cysts and what can be done for the continued back and leg pain? Dealing with this for several years has caused me much emotional distress and depression. — F.H.

ANSWER: Tarlov cysts, also called perineurial cysts, occur along the lining of the spinal cord and nerve roots. In one study, in 500 people with MRI scans, 23 had Tarlov cysts, but only five had any symptoms from them. In this study, the cysts were drained by a needle, which relieved the pain, although the pain usually came back as the cysts refilled with fluid.

I agree with your neurosurgeon that surgery on these does not guarantee success.

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