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A case of symptomatic cervical perineural (Tarlov) cyst: clinical manifestation and management

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Abstract

Perineural (Tarlov) cysts are most often found in the sacral region and are rare in the cervical spine. Although they are usually asymptomatic, a small number of those at the lumbosacral level have been known to produce localized or radicular pain. Few reports are available on symptomatic perineural cysts in the cervical spine and it has not been discussed how they should be managed. We present here a case of cervical perineural cysts with persistent radicular pain where the pain was adequately managed with repetitive transforaminal epidural steroid injection (TFESI). The patient had experienced intractable pain in the posterior neck and left upper extremity for more than 7 years. The nature of the pain was cramping and a tingling sensation, which was aggravated in the supine position. Magnetic resonance imaging revealed a perineural cyst in the neural foramen of left C7 root. The patient underwent three repetitive TFESIs targeted at the root. Each injection provided incremental relief, which lasted more than 6 months. Follow-up image revealed shrinkage of the cyst. This case illustrates in detail the clinical manifestation of a rare symptomatic perineural cyst in the cervical region and to our knowledge is the first to report the beneficial effect of repetitive TFESI.

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Acknowledgement

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Rehabilitation Medicine, Seoul National University College of Medicine, Room # 12611, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea

    Keewon Kim

  2. Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea

    Keewon Kim

  3. Department of Rehabilitation Medicine, Seoul National University College of Medicine, Room # 12608, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, Korea

    Se Woong Chun

  4. Rheumatism Research Institute, Medical Research Center, Seoul National University, Seoul, Korea

    Sun G. Chung

  5. Department of Rehabilitation Medicine, Seoul National University College of Medicine, Room # 12327, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea

    Sun G. Chung

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  1. Keewon Kim
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  2. Se Woong Chun
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  3. Sun G. Chung
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Correspondence to Sun G. Chung.

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Kim, K., Chun, S.W. & Chung, S.G. A case of symptomatic cervical perineural (Tarlov) cyst: clinical manifestation and management. Skeletal Radiol 41, 97–101 (2012). https://doi.org/10.1007/s00256-011-1243-y

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  • DOI: https://doi.org/10.1007/s00256-011-1243-y

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