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Functional recovery following resection of large Tarlov cyst malformation: a multicentre longitudinal cohort study

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Abstract

Objective

The authors report their experience with 44 consecutive patients who underwent cyst fenestration and wall repair or cerebrospinal fluid communication closure for the management of sacral Tarlov cysts.

Methods

The procedure was performed on 32 women and 12 men with a mean age of 42 years. Clinical complaints in all patients included lumbar-sacral aching, sphincter dysfunction perineal pain, and sexual intercourse pain. The patients’ symptoms had developed within a mean time period of 45 months. Five patients had a previous cyst puncture. In all patients, the cyst was exposed through a sacral laminectomy. In 30 patients, the cyst was partially resected its wall repaired, and in the remaining patients, the cyst was fenestrated, and the cerebrospinal fluid communication was located and tamponaded. Thirty-seven patients had intraoperative EMG monitoring. While the perineal pain, urinary, or sexual dysfunction improved in all patients, eleven patients reported lasting pain control following surgery. The cyst was reduced in all resected cases and seven of 14 patients with CSF tamponade. The mean length of the follow-up period was 57 months.

Conclusions

Either cyst repair or CSF tamponade can be sufficient for alleviating symptoms in patients with Tarlov cyst. Advice should be given to patients regarding expectations for pain improvement after surgery.

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Authors and Affiliations

  1. Regional Service of Neurosurgery, “Virgen de la Arrixaca” University Hospital, El Palmar, E-30120, Murcia, Spain

    Marcelo Galarza, Pedro de la Rosa & Miguel Marin Laut

  2. Department of Neurosurgery, San Giovanni–Addolorata Hospital, Rome, Italy

    Roberto Gazzeri

  3. Neurosurgery Unit, Hospital Quiron Torrevieja, Torrevieja, Spain

    Marcelo Galarza, Gerald Chaban & Cristian Garcia Montoya

  4. Department of Neurosurgery, Hospital Alemán de Buenos Aires, Buenos Aires, Argentina

    Fidel Sosa

Authors
  1. Marcelo Galarza
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  2. Gerald Chaban
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  3. Roberto Gazzeri
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  4. Pedro de la Rosa
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  5. Cristian Garcia Montoya
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  6. Miguel Marin Laut
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  7. Fidel Sosa
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Contributions

These authors contributed equally to this work. Dr Galarza: design and main writer; Dr Chaban: editing the paper; Dr Gazzeri: analysis and literature; Drs Garcia, De la Rosa, Marin, and Sosa: analysis of material.

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Correspondence to Marcelo Galarza.

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The authors declare no competing interests.

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This article is part of the Topical Collection on Spine - Other

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Galarza, M., Chaban, G., Gazzeri, R. et al. Functional recovery following resection of large Tarlov cyst malformation: a multicentre longitudinal cohort study. Acta Neurochir 163, 2769–2776 (2021). https://doi.org/10.1007/s00701-021-04817-z

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  • DOI: https://doi.org/10.1007/s00701-021-04817-z

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