We may be familiar with some back injuries, especially at the level of the lumbar, but the Tarlov cyst goes further. It is a situation that normally does not have specific symptoms and is confused with others such as low back pain. So confusing is everything that we have proposed to answer and learn to detect if we have this cyst or our pain comes from something else.
A Tarlov cyst is very easy to detect and is usually found by chance when the patient was going to have an X-ray or MRI of the back, especially the lower area. This cyst is located near the coccyx and is related to one of the causes of low back pain, although it is something that to date has not been 100% proven.
The Tarlov cyst remains a small mystery in modern medicine, although many things are known about it, such as, for example, what it is, how it is formed, some possible causes of its appearance and the most common symptoms, although most of patients are asymptomatic.
What is and how is a Tarlov cyst formed?
Simply put, they are cerebrospinal fluid-filled masses that develop in the meninges of the spine. For those who do not know, the meninges are internal layers called the pia mater and the arachnoid that help protect the spinal nerves of the spine. The most common place where these cysts appear is the lumbar or sacral area, although it is likely that they also appear in the thoracolumbar and coccygeal spine.
These types of cysts are known as perineural, periradicular or arachnoid cysts and this one in particular was discovered in 1938 by Dr. Tarlov , hence the name. These types of cysts are complex, difficult to treat and pose a certain risk to the health of the patient since the spinal nerves are part of the cyst itself, so when performing surgery, one or more nerves could break causing serious injuries to the patient.
These cysts are more prone in women than in men and there are different treatments to make them disappear, and among them the importance of a healthy diet, which, in this case, would be an alkaline diet. It consists of a diet that increases the pH of the body since this type of diet is based on the belief that many diseases develop due to having a low pH.
What are the causes?
This cyst has a series of causes, but none has been proven to be 100% related, so there is talk of hypothesis. On the one hand, it is said that its origin could be a trauma in the area since it is a sac with cerebrospinal fluid that has no outlet, only inlet. Another cause that is considered is due to the use of anesthesia in the epidural area.
There is also the issue of congenital alterations . This hypothesis focuses directly on some type of irregularity in the formation of the membranes that surround the brain known as meninges. Other causes include subarachnoid hemorrhage.
As we see there are no concrete causes. What the experts do seem to agree on is that the appearance of these cysts is due to an increase in the local pressure of the cerebrospinal fluid together with an abnormal valve phenomenon that allows that fluid to enter the cyst, but cannot exit.
Does the Tarlov cyst have symptoms?
We have already advanced it a few paragraphs above and it is that the Tarlov cyst is asymptomatic , so it does not present concrete and remarkable symptoms that make us suspect that we have a cyst in our sacral area. The vast majority of times these cysts are asymptomatic and are discovered by chance by a radiological test that sometimes is not even looking for anything on the back.
We say “the vast majority”, because there are cases in which there are certain symptoms where pain stands out above all. Remember that within these cysts there are arms of nerves and as the size of the cyst increases (not all of them grow) the pressure increases and the nerves begin to be affected, resulting in consequences such as pain. In some cases the pain is bearable and is fixed with medication and in other cases the pain is so severe that serious measures must be taken.
When that symptom appears, we have low back pain, which is why Tarlov’s cyst is sometimes believed to be the cause of low back pain and can only be demonstrated with an MRI. From there, a race begins to find a solution, calm the pain and be able to lead a normal life.
Diagnosis and treatment
We have already launched a spoiler without realizing it and that is that the diagnosis is made using radiological plates and MRIs, although there are also CT scans. It will be the doctor who decides what tests to carry out to assess the cyst and propose a more or less effective treatment.
The real problem with this type of cyst is that it increases in size, but it is uncommon for the cyst to change in size, so we can be calm and make specific reviews to see that it is still in place and everything is “fine”.
Current treatments are usually based on the patient’s symptoms, that is, if it does not hurt and does not change in size, it is monitored every 6 months or a year. However, when it begins to cause pain and changes in size, you have to act.
One of the most common treatments is physiotherapy, anti-inflammatory or analgesic medications, but there is a point where the pain is unsustainable and you have to act more emphatically and that is when the possibility of surgery is planted on the table.
The most common and least risky operation is the option to empty the cyst and seal it so that it does not refill with fluid . Tarlov cyst removal is much more complex and risky, so it is not a highly recommended option.
