Prospective Validation of a Quality-of-Life Measure for Women Undergoing Surgical Intervention for Symptomatic Sacral Tarlov Cysts: The Tarlov Cyst Quality of Life Scale.
World neurosurgery
BACKGROUND:The use of health-related quality-of-life scales has expanded into most areas of medicine. Established quality-of-life scales are used in several areas of neurosurgery, but none have been validated for use in patients with symptomatic Tarlov cysts. The majority of symptomatic Tarlov cysts are found in the sacral spinal canal of women. We, therefore, validated a site-specific quality-of-life measure for women with symptomatic sacral nerve root compression caused by Tarlov cysts. METHODS:Women undergoing surgical treatment for sacral Tarlov cysts at a single institution between 2017 and 2020 were enrolled in this prospective validation study. Participants were administered a 13-item version of the survey along with other validated quality-of-life measures preoperatively and at 3 months postoperatively. Psychometric analyses were performed to validate the measure. RESULTS:One hundred twelve patients met inclusion criteria and completed surveys preoperatively and at 3 months postoperatively. Patients' mean scale scores decreased significantly preoperatively to postoperatively, reflecting good discriminability (P < 0.001). Interitem correlations suggested 2 items were correlated at >0.80, which were dropped to create an 11-item scale. The internal consistency of the 11-item scale was 0.822. Concurrent validity was established by correlating scale scores with the Oswestry Disability Index (P < 0.001) and the physical function (P < 0.001) and pain (P < 0.001) subscales of the Short-Form 36 Survey. CONCLUSIONS:We prospectively validated a site-specific, health-related quality-of-life survey for women with symptomatic sacral Tarlov cysts. This measure will be useful in future studies to inform clinicians and researchers about the progression of Tarlov cysts and patient response to surgical treatment.
10.1016/j.wneu.2022.06.033
Sacral canal myeloid sarcoma as initial manifestation of granulocytic leukemia: MRI features and differential diagnosis (with a case report).
Anqi Xiao,Siqing Huang,Zhenlin Li,Chao You
Turkish neurosurgery
Myeloid sarcoma initially occurring in the sacral canal is often misdiagnosed as other pathological tumors on MRI due to the lack of a definite history or clinical evidence of granulocytic leukemia. Here, we report a case of 24-year-old male patient with myeloid sarcoma misdiagnosed radiologically. On MRI, sacral myeloid sarcoma is characterized by homogeneous signal intensity, marked enhancement, and the lack of cystic degeneration, calcification and necrosis. Based on our study of this patient and review of the relevant literature, we believe that these MRI features in the sacral region may help us differentiate it from other pathological tumors, which could prompt further clinical examinations to confirm the diagnosis of granulocytic leukemia.
10.5137/1019-5149.JTN.7125-12.1
Giant cystic sacral schwannoma mimicking tarlov cyst: a case report.
Attiah Mark A,Syre Peter P,Pierce John,Belyaeva Elizaveta,Welch William C
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
PURPOSE:To present a rare case of a giant schwannoma of the sacrum mimicking a Tarlov cyst. METHODS:A 58-year-old woman had a 1-year history of low back pain. MRI revealed a large cystic mass in the sacral canal with bony erosion. Radiological diagnosis of Tarlov cyst was made. RESULTS:The patient underwent surgical treatment for the lesion, which revealed a solid mass. Histopathological examination of the tumor confirmed the diagnosis of schwannoma. The postoperative course was uneventful and the patient has had significant improvement in her pain 1 month postoperatively. CONCLUSION:Giant cystic schwannoma of the sacrum is a very rare diagnosis overlooked by practitioners for more common cystic etiologies, but its treatment is significantly different. Care should be taken to include this diagnosis in a differential for a cystic sacral mass.
10.1007/s00586-015-4128-2
Percutaneous Endoscopic Treatment for a Symptomatic Sacral Tarlov Cyst.
Zhang Bin,Dou Qingyu,Feng Pin,Kong Qingquan
World neurosurgery
BACKGROUND:Symptomatic sacral Tarlov cysts have been associated with perineal or sacral pain, radiculopathy, and urinary dysfunction. The ideal treatment of symptomatic sacral Tarlov cysts remains a matter of discussion. Various open surgical procedures have been proposed, varying from placement of shunts and clipping to laminectomy and fenestration; however, those procedures are often associated with recurrence, cerebrospinal fluid leakage, infection, and other complications. A percutaneous endoscopic surgical procedure to address this problem has not been described to date. CASE DESCRIPTION:A 21-year-old man presented with perineal and left lower extremity pain. Magnetic resonance imaging demonstrated a sacral Tarlov cyst protruding through the left S2 canal. Through a small laminectomy at S2, the posterolateral wall of the cyst was exposed. The incision was continued from the neck to caudal of the cyst. The cyst wall was resected step by step. The fenestration was performed at the neck of the cyst with scissors. His lower extremity and perineal pain improved progressively during the first day postoperatively, and there were no signs of cerebrospinal fluid leakage, infection, or other complications. No further cyst formation or complications were recorded after 6 months. CONCLUSIONS:In this case report, we describe a percutaneous endoscopic approach to surgical resection of a Tarlov cyst that was performed safely and effectively. This novel minimally invasive strategy may have broad prospects for symptomatic sacral Tarlov cysts; however, due to the limitations of a single case, more reported cases and further controlled studies of this novel technique are needed.
10.1016/j.wneu.2018.05.177
Surgical excision of symptomatic sacral perineurial Tarlov cyst: case series and review of the literature.
Elsawaf Ahmed,Awad Tariq Elamam,Fesal Salem S
European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
OBJECT:Symptomatic sacral perineural cysts are extremely rare. The aim of this retrospective study is to investigate the outcome of 15 consecutive patients treated by microsurgical resection of the cyst and to review the literature. METHODS:The authors retrospectively reviewed their clinical data archive from 2002 to 2014. Fifteen patients who were operated on due to symptomatic sacral perineural cysts were enrolled in the study. Patients' symptoms, radiographs, intra-operative findings, and clinical results were evaluated. All 15 patients underwent microsurgical excision of the cyst. The literature on this topic available in PubMed was also reviewed. RESULTS:There were 5 men and 10 women included in the study, with a mean age of 31 years (range 7-60 years). Preoperative symptoms include low back pain, coccydynia, buttock pain, perianal pain and radicular pain. All of the patients underwent surgical resection. The mean follow-up was 54 months (range 3-160 months). All the patients experienced complete or substantial resolution of the preoperative local and radicular pain after surgery. CONCLUSIONS:Cyst excision is an effective and safe technique for symptomatic sacral perineural (Tarlov) cysts. Careful patient selection is vital to the management and treatment of this difficult and controversial pathology.
10.1007/s00586-016-4584-3
Huge anterior sacral meningocele simulating bladder retention.
Castelli Emanuele,Rosso Rodolfo,Leucci Giuliana,Luparello Vincenzo,Collura Devis,Giacobbe Alessandro,Muto Giovanni
Urology
Anterior sacral meningocele (ASM) is a rare congenital disorder involving herniation of the dural sac through a defect in the anterior surface of the sacrum. We report the case of a young patient with an enormous ASM that simulated bladder retention in terms of symptoms as well as on physical examination and at ultrasonography. After introducing a catheter that excluded urinary retention, computed tomography (CT) scan and magnetic resonance imaging (MRI) showed the ASM. The patient underwent surgical repair of the ASM through a sacral laminectomy and recovered normal lower urinary tract function.
10.1016/j.urology.2012.11.015