DOI: 10.21276/aimdr.2019.5.3.OR2
Original Article ISSN (O):2395-2822; ISSN (P):2395-2814
Annals of International Medical and Dental Research, Vol (5), Issue (3) Page 5
Section: Orthopaedics
MRI Spectrum of Symptomatic and Non –Symptomatic
Tarlov Cyst: Series of Seven Cases in Orthopaedic
Management Point of View.
Viney Kumar Govila
1
, Naresh Chander Arora
2
, Hira Lal Kakriya
3
, Meghna Varma
4
, Nitish
Virmani
5
, B B Sharma
6
1
Assistant Professor, Department of Orthopedics, SGT Medical College, Gurugram (Haryana) 122505.
2
Professor, Department of Orthopedics, SGT Medical College Budhera (Gurgaon) 122505.
3
Professor & HOD, Department of Orthopedics, SGT Medical College Budhera (Gurgaon) 122505.
4
Post Graduate MD Radiodiagnosis, Department of Radio-diagnosis, SGT Medical College Budhera (Gurgaon) 122505.
5
Assistant Professor, Faculty of Allied Health Sciences, SGT University, Gurgaon (Haryana).
6
Professor & Head, Dept.of Radio-diagnosis,SGT Medical College Budhera (Gurgaon) 122505.
Received: March 2019
Accepted: March 2019
Copyright: © the author(s), publisher. Annals of International Medical and Dental Research (AIMDR) is an
Official Publication of “Society for Health Care & Research Development”. It is an open-access article distributed
under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-
commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
INTRODUCTION
Tarlov cyst is a perineural CSF filled cyst which is
having the neve root within it. These are the
meningeal dilatation with CSF present on the
dorsal nerve root. These can be differentiated from
pure meningeal cysts because of their nerve fibre
walls. These are responsible for various
myelopathies depending upon size, shape,outline
and their extension in the surrounding anatomical
structures. These affects the dorsal roots and
produce symptomatology accordingly. These cysts
were named after the renowned neurorologist
Isadore M Tarlov. He studied thirty cadaveric filum
terminale in 1938 at Montreal Neurological
Institute to describe these type of perineural
cysts.
[1]
MATERIALS AND METHODS
There were seven patients (n=7) who were found to
be having these perineural cysts during the MRI
scanning of lumbosacral region. Five patients were
male (71.4%) and two female (28.6%) in the age
Name & Address of Corresponding Author
Dr. B B Sharma
Professor & Head,
Department of Radio-diagnosis, SGT Medical College
Budhera (Gurgaon) 122505
C 35 First Floor,
Anand Niketan,
New Delhi - 110021
ABSTRACT
Background: Tarlov cysts are perineural cysts and are usually found in sacral region. The dorsal nerve root is
encased in this type of the cyst. These may or may not be with any of the symptomatology. The entity is
infrequently found as an incidental finding. These are cerebrospinal fluid (CSF) filled sacs which are diagnosed
on cross sectional imaging modalities especially in magnetic resonance imaging (MRI). Tarlov cysts can cause
different type of myelopathies as per their location and size. Methods: We present a series of seven cases
where these perineural cysts were found during the routine imaging of lumbosacral spine. All these patients had
undergone Magnetic Resonance Imaging (MRI) of lumbosacral spine for backache or some other pelvic
complaints. In one case Computerized Tomography (CT) Myelography also helped in diagnosis and related
bone remodeling.MR myelography adds to the delineation of CSF wrapping around the spinal cord. Results:
Three patients were found to be symptomatic and the intensity of complaints corresponded to the size and
location of the cysts. In our three cases, the etiopathogenesis also corresponded to the underlying development
of these entities. Four patients were asymptomatic as the size of these cysts were small and not contributing to
the complaints of the patient. Conclusion: MRI is the best modality to diagnose these perineural cysts which
are responsible for different types of myelopathies .T2WI sequences in non contrast MRI studies are the best in
delineating the size, shape, outline and location of these cysts. This also further elaborates their extension to
the surrounding regions.MR myelography is adjuvant to more morphological features of these cysts.
Keywords: Tarlov cyst; CSF; MRI; CT Myelography; myelopathies.