Acta Neurochirurgica

, Volume 160, Issue 4, pp 839–844 | Cite as

Can patients with symptomatic Tarlov cysts be differentiated from patients with specific low back pain based on comprehensive history taking?

  • Maria Anna Hulens
  • Wim Dankaerts
  • Ricky Rasschaert
  • Frans Bruyninckx
  • Marie-Laure Willaert
  • Charlotte Vereecke
  • Greet Vansant
Original Article - Spine



Tarlov cysts (TCs) are expanded nerve root sheaths that occur near the dorsal root ganglion and result from increased intraspinal hydrostatic pressure. TCs most frequently affect the lumbosacral plexus and therefore may cause specific symptoms such as perineal pain and neurogenic bladder, bowel, and sphincter problems. It has been estimated that 1% of the population has symptomatic Tarlov cysts (STCs). However, STCs appear to be underdiagnosed, with the pain reported by patients commonly attributed to degenerative alterations seen on MRI. The aim of the present study is to investigate the utility of a comprehensive questionnaire for use by physicians in establishing the diagnosis of STCs.


We compared questionnaire responses regarding patient history between 33 patients diagnosed with symptomatic TCs and 42 patients with chronic low back pain and sciatica due to disc problems or degenerative or inflammatory disorders. The diagnosis of STCs was confirmed using nerve conduction studies (NCS) and electromyography (EMG) of the sacral myotomes by an expert neurophysiologist.


The questionnaire responses revealed specific differences in perineal symptoms (perineal pain, dyspareunia, coccygodynia), bowel symptoms (constipation, diarrhea), bladder symptoms (hesitation, retention, frequency), and anal sphincter problems (anal pain, mild fecal incontinence). Additionally, sitting, walking, and straining aggravated pain more frequently in STC patients, and STC patients were more often forced to stop working and/or reduce their social activities.


Including the above-listed items in the patient history might facilitate differentiation of low back pain and sciatica due to STCs from that due to disc problems or degenerative or inflammatory disorders.


Tarlov cysts Perineal pain Non-specific low back pain Ischialgia 



We thank Debbie West and Frank Feigenbaum for permission to use their International Tarlov Cyst Questionnaire (Feigenbaum Neurosurgery PA, Dallas, TX and Cyprus). We also thank Anouchka Laenen for statistical assistance.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

For this type of study, formal consent is not required.


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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Maria Anna Hulens
    • 1
    • 2
  • Wim Dankaerts
    • 1
  • Ricky Rasschaert
    • 2
  • Frans Bruyninckx
    • 3
  • Marie-Laure Willaert
    • 1
  • Charlotte Vereecke
    • 1
  • Greet Vansant
    • 4
  1. 1.Musculoskeletal Rehabilitation Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation SciencesUniversity of LeuvenHeverleeBelgium
  2. 2.Department of NeurosurgeryZNA MiddelheimAntwerpBelgium
  3. 3.Clinical Electromyography LaboratoryUniversity Hospitals UZ LeuvenLeuvenBelgium
  4. 4.Department of Social and Primary Health Care, Public Health NutritionUniversity of LeuvenLeuvenBelgium

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