Prevalence and Percutaneous Drainage of Cysts of the Sacral Nerve Root Sheath (Tarlov Cysts)

PURPOSE: To describe a percutaneous CT-guided method for drainage of perineurial (Tarlov) cysts, which are a cause of sciatica and low back pain, and to report the prevalence of these cysts within the population as detected by MR. METHODS: Five hundred sequential lumbosacral spine MRs were evaluated for the presence of a perineurial cyst. Using CT-guided percutaneous drainage techniques, seven cysts were drained in five symptomatic patients. RESULTS: Of the 500 sequential lumbosacral spine MRs, examinations from 23 patients showed perineurial cysts, a prevalence of 4.6%. Five patients (1 %) were symptomatic from the cysts. After CT-guided percutaneous drainage, instant pain relief lasted from 3 weeks to 6 months without the risk or cost of spine surgery. CONCLUSIONS: Lumbosacral perineurial cysts are common lesions that are usually asymptomatic but may cause pressure symptoms. Cyst puncture can alleviate the pain. Although the cysts repressurized and the patients ' symptoms returned in most cases, this technique seems to be a quick and simple way of at least attaining a pain-free interval and possibly a complete cure as occurred in one patient in this study