A Case Report of Perineural Cysts, Also Known as Tarlov Cysts

Dijana Zadravec, Petra Margetic, Mia Smoljan, Ivana Zupetic

International Journal of Biomedicine. 2019;9(1):66-68.
DOI: 10.21103/Article9(1)_CR1
Originally published March 15, 2019


Tarlov cysts (TCs) are a rare but intensive cause of chronic low back pain or lumbosacral radiculopathy and should be considered in the differential diagnosis of radicular symptoms. Magnetic resonance imaging (MRI) is the radiologic study of choice to visualize these cysts. In the current study, we describe a case of a 49-year-old patient with intermittent pain on his coccigeal region, right buttock, and intensive pain in the right hip and inner side of the thigh, in 1.5 years of duration. MRI of the lumbosacral spine and hip showed right-sided, sacral S2 and S3 perineural cysts, the largest located at the right S2 nerve root. Conservative treatment of sacral perineurial cysts should be the first choice. The surgical treatment is recomended in cases when MRI scans reveal a large (1.5 cm) cyst associated with neurological symptoms and no response on conservative treatment.

meningeal cyst • Tarlov cyst • CT myelography • MRI
  1. Nabors MW, Pait TG, Byrd EB, Karim NO, Davis DO, Kobrine AI, Rizzoli HV. Updated assessment and current classification of spinal meningeal cysts. J Neurosurg. 1988;68(3):366–77.
  2. Mummaneni PV, Pitts LH, McCormack BM, Corroo JM, Weinstein PR. Microsurgical treatment of symptomatic sacral Tarlov cysts.  Neurosurgery. 2000;47(1):74-8; discussion 78-9.
  3. Park HJ, Jeon YH, Rho MH, Lee EJ, Park NH, Park SI,  Jo JN. Incidental findings of the lumbar spine at MRI during herniated intervertebral disk disease evaluation. AJR Am J Roentgenol. 2011;196(5):1151–5.
  4. Tarlov IM. Spinal perineurial and meningeal cysts. J Neural Neurosurg Psychiatry. 1970;33(6):833–43.
  5. Caspar W, Papavero L, Nabhan  Loew AC , Ahlhelm F. Microsurgical excision of symptomatic sacral perineural cysts: A study of 15 cases. Surg Neurol. 2003;59(2):101–5; discussion 105-6.

Download Article
Received February 2, 2019.
Accepted March 11, 2019.
©2019 International Medical Research and Development Corporation.