Quistes de Tarlov: tres casos sintomáticos

Tarlov cysts (perineural cysts) are an ectasia of the perineural space of the spinal nerve roots. They are usually at or beyond the junction of the dorsal ganglion and the posterior root. Most frequently, they are located on the sacral level. In most cases, they are asymptomatic, although low back pain or radicular symptoms have been reported. We present three women, between thirty and fifty years of age, with a sacral radiculopathy. All the patients underwent a normal complete neurological examination. Diagnosis of sacral perineural cyst was confirmed in all patients, using magnetic resonance imaging (MRI) of the lumbosacral spine. The cysts were smaller than 1.5 cm in diameter. In one case, an electromyography study showed normal values. Rehabilitation treatment and non-steroid anti-inflammatories were administered. In two cases, the patients reported recurrence of neuropathic pain. Amitriptyline and gabapentin were then prescribed and these patients experienced total remission of pain. Tarlov cysts are a rare cause of low back pain and radiculopathy but they should be considered in the differential diagnosis. Management of symptomatic cysts is controversial. It is suggested that patients with small Tarlov cysts (< 1.5 cm) do not require surgical treatment and they should undergo conservative measures.