When the nerve root sheaths that are located at the base of the spine start to form abnormal sacs that fill up with cerebrospinal fluid, these are called tarlov cysts or sacral nerve root cysts. They can be the main cause of chronic pain that resides at the base of one's back, since the main nerves surrounding that area are most affected. The cysts can appear in more than one part of the spine, which include parts like the lumbar, cervical, sacral and thoracic regions.
The most common part of the spine for these cysts to occur are at the sacrum. These contain five sacral vertebrae that merge together to form a common triangular bone structure above the sacrum, along with coccygeal vertebrae that meet at the tailbone below the sacrum. Along these regions are where the cysts can take root. The cysts form when the sheaths dilate from the nerve roots, that connect to the subarachnoid area of the spine, where the collected cerebrospinal fluid runs through.
When patients go for MRI scans, they come forth with no apparent symptoms showcased but with the cysts present around their spinal columns anyway. These are not made known to the patient by the radiologist since they pass this over as something that doesn't pose as a threat. Only after years of being ignored and looked over, do the cysts then start to alter and degenerate the structure of the sacral bone or other parts of the spine. Once these start to progress in size they apply pressure to nerve fibers in the affected area, where the symptoms then start to come forward with chronic pain evident.
To identify a tarlov cyst is to take a close look at its characteristics like, multiplying while spreading around the circumference of a nerve root; the cyst's walls have nerve fibers that are thin and can be easily punctured during surgery (thus making it difficult to surgically treat); there is delayed filling in the myelograms and these move freely towards the spinal subarachnoid space.
The causes that can be the reason for the occurrence of this cyst can be due to many pertaining factors that lead up this problem.
- Trauma to the spine due to accidents or falls
- Cerebrospinal fluid blockage
- Increased pressure due to cerebrospinal fluid
- Lifting heavy objects
- Cyst growth
- Marfan syndrome
The symptoms that are portrayed aren't very different when it comes to men and women, and are those that require both sexes to keep an eye out for.
- Pain residing in areas like the legs, lower back, abdomen, vagina, buttocks and rectum
- Cramping or weakness in the aforementioned body parts
- Bowel or bladder problems
- Not able to stand or sit without feeling pain
- Nerve pain, leading to burning, tingling or numbness
- Sexual problems
- Reflexes aren't coordinated
- Constant headaches
- Feeling a sore, tender or a swelling bump around the lower part of the spine area
- Cauda equina syndrome
- Hardened sensation while sitting
- Radicular pain
- Hurts when you sneeze / cough
- Cramping in the arm region
- Tailbone region at the base of your lower back feels like its being pulled
- Retrograde ejaculation
- Burning sensation in tailbone area
- Pressure sensations behind the eyes
- Blurry vision
- Feeling disoriented
- Sometimes there is no pain although there is a dysfunctional problem that is linked to one's libido and bladder function.
Tarlov Cyst TreatmentThe treatment options available to help treat tarlov cysts are a varied number of alternatives that patients can try out.
TENS or Transcutaneous Electrical Nerve Stimulation
For those experiencing extreme pain due to the implanted cyst, electrical impulses are sent through one's skin to help patients deal with this sensation. Intramuscular corticosteroid injections are also given to patients to help ease chronic pain.
This method of treatment is done on patients who are experiencing a complete degeneration of the spinal bone or sacrum, whose bowel and bladder problems have not improved and who have symptoms of pain and other signs of the same that have escalated in severity.
These patches are ideal for those who need immediate but temporary relief from the pain, by placing these on the base of the spine where the pain originates. Non-steroidal anti-inflammatory drugs are prescribed to patients, to help deal with the pain as well.
Fibrin Glue Injection with Aspiration of the Cyst
The cyst is first drained of the fluid that's been building inside of it and is then replaced with a special glue, that helps the cyst prevent fluid from seeping in and filling into it again.
Tarlov cysts can be quite bothersome and painful to have to deal with, that is why it is important to check one's family's medical history, and get checkups done should even the slightest recurrent pain reside along your spinal area. Make sure that you have cysts treated even if the symptoms haven't come forth yet, to avoid future problems after it has advanced. Have a safe tomorrow.