WHAT IS A TARLOV CYST or PERINEURAL CYST?
A Tarlov Cyst or Perineural Cyst is a dilated nerve root sheaths with cerebrospinal fluid. Tarlov cysts (Perineural Cysts) are found most commonly in the sacral region and to be more specific, at the S2-S3 level of the spine. Nevertheless, you can get a Perineural Cyst (Tarlov Cysts) in other areas of the spine. Also, it could be present in multiple areas.
Tarlov cyst is not the source of pain in patients with neck pain, upper back pain, mid back pain, low back pain or extremity pain. In fact, 98% of diagnosed cases, the Tarlov Cyst or Perineural Cyst is not the source of pain. However, a Perineural Cyst can aggravate an existing disorder. Although, cysts measuring more than 20mm can be the source of pain when there are no other clinical findings are present. If the Tarlov Cyst or Perineural Cyst is too big, it can pinch and irritate neural structures.
How is Tarlov Cyst (Perineural Cyst) Diagnosed?
The only acceptable means of diagnosis for a Perineural Cyst is through an MRI. The Magnetic Resonance Imaging (MRI) is the gold standard for diagnosing a spine-related condition. And, when it comes to a Tarlov cyst, there is nothing better. The best MRI view of a Tarlov cyst is the T2-weighted MRI images. The T2-weighted images enhance fluid levels as such making the diagnosis of a Tarlov cyst relatively easy. On a T2-weighted MRI, a Tarlov Cyst will appear to be a white ballooned/dilated area of the sheath that covers the exiting sacral nerve roots.
As mentioned, dilation of the nerve root sheaths is the source of a perineural cyst. The dilation is the result of excessive accumulation of CSF (cerebrospinal fluid) within the nerve sheath. Now, let’s look into the layers of nerve sheaths where these fluid collections occur. Three meningeal layers cover the brain and the spinal cord; the outer most and the toughest layer would be the dura mater, followed by the arachnoid and the innermost layer is called the pia mater. Subarachnoid space is the space between the pia and arachnoid mater.
What are the Signs and Symptoms of a Perineural Cyst (Tarlov Cyst)?
The presence of a Perineural Cyst may or may not be accompanied by neurologic symptoms. However, living with a Tarlov cyst for years will start remodeling and erosions of the sacral bone. This, in turn, may lead to increased spinal fluid pressure causing the cyst to fill-up with CSF. The larger cysts can compress the surrounding nerve fibers. Patients with large cysts may experience pain in the legs or spine. Cysts that grow as often injured or irritated.
Traumatic accidents, infections, falls, childbirth or epidurals can transform an asymptomatic cyst to become symptomatic. Symptoms of an enlarging Tarlov Cyst or Perineural Cyst would be similar to sciatica or slip-disc. Patients would experience either localized or radiating pain, numbness, paresthesia, and tingling. A patient with a Perineural Cyst, however, would also complain about soreness or pain in the sacral region. Bowel and bladder changes may also occur. Pain may increase with a cough or sneeze, and they may have headaches or dizziness.
What Should You Do if You Have a Tarlov Cyst or Perineural Cyst?
As mentioned earlier, a Tarlov cyst is often not the cause of pain. Medical research has established the fact the 98% of Perineural Cyst cases is not the source of pain. In fact, in the majority patients diagnosed with a Tarlov cyst are those that suffer from spinal disc disorders such as a herniated disc (slip-disc or slipped disc). Therefore, clinical expertise and judgment are needed when it comes to treating patients that present with a Tarlov cyst. In our centers, we have treated thousands of patients with Tarlov cysts. In almost all cases, the pain was not due to their cyst.
Tarlov cysts are often a complicating or aggravating factor. Much like when you cut your finger while cooking and not feeling the pain until you touch slat or an acidic liquid like lemon juice. Similarly, the Tarlov cyst is an aggravating factor, especially when you have a spinal disc disorder or a joint malfunction. In other words, the spinal disc or spinal joint is the source of pain rather than the cyst. Just like the pain, you feel when your cut finger comes in contact with salt or lemon juice.
Non-Invasive Therapy Options for the Tarlov Cyst or Perineural Cyst
The clinical teams of Chiropractic Specialty Center are experts in the spine and joint conditions. Our expertise and successes achieved are the results of our research-based clinical treatment we provide. Our Chiros are the expert you need in identifying the causes of your pain. Too often, patients with a Tarlov Cyst receive improper therapeutic procedures. The absence of an accurate diagnosis is the primary factor of ineffective treatment. Diagnosis is the most challenging aspect of your care. As such, our clinical teams will carefully assess you to ensure a speedy recovery.
Our methods of treatment for the spine have improved the lives of thousands of our patients. In fact, we have helped many that others could not. Our successes in the area of the spine and joint care are due to our commitment to research and understanding of causes. If you have a Tarlov cyst, your best hope of recovering from pain through non-invasive manner is us. Our methods of integrative treatments coupled with advanced spine technology allow us to deliver for you a world-class level of care unmatched by others. Visit us today and discover your non-surgical treatment options for a Tarlov Cyst or Perineural Cyst today.