Tarlov Cyst Ablation



Tarlov cysts are nerve root cysts found most often at the sacral level of the spine. They typically arise along the posterior nerve roots, and about 1 in 5 patients may develop back or leg pain related to pressure of the cerebrospinal fluid on nerves or adjacent structures. These symptoms can be confused with more common diseases including herniated lumbar discs, arachnoiditis, and some gynecological conditions.

Tarlov cyst surgery is challenging and the results uncertain. Some patients have been helped, but some are worse after surgery according to studies conducted at University of California San Francisco (imbrication-fat grafting) and Georgetown University (ligation-resection). We perform fibrin glue and cryoprecipitate injections and have one of the largest series nationally. This is performed in a day surgery setting. The procedure takes about an hour with CT guidance using conscious sedation. Patients remain in the hospital for a few hours of observation prior to discharge. Work is ongoing to determine the true, long term, efficacy.