Brief reportTwo-Needle Technique for the Treatment of Symptomatic Tarlov Cysts
Section snippets
Case Report
A 64-year-old woman presented with an 18-month history of chronic pelvic and left lower extremity pain. The patient was bedridden for most days despite constant narcotic medication. Informed consent was obtained after discussion of the potential risks and benefits, including infection and meningitis. Diagnostic CT was performed (Aquilion 16-section multidetector CT unit; Toshiba, Nasu, Japan), and the level providing the best access to the cyst through the thinnest overlying bone was chosen (
Discussion
Tarlov cysts can be characterized by either narrow or wide neck connections with the lumbosacral subarachnoid space. Narrow-necked cysts can enlarge by means of a net inflow of cerebrospinal fluid through a valvelike mechanism, eventually causing symptoms by distorting, compressing, or stretching adjacent nerve roots. In their series of 24 cysts documented in 19 patients, Davis et al (4) found no significant difference in size between symptomatic and asymptomatic cysts (P > .05); however, they
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None of the authors have identified a conflict of interest.