Surgical Excision of Symptomatic Sacral Perineurial Tarlov Cyst

Background: Symptomatic sacral perineurial cysts are extremely rare. Objective: The aim of this retrospective study was to investigate the outcome of fifteen consecutive patients treated by microsurgical resection of the cyst. Patients and Methods: The authors retrospectively reviewed their clinic data archive from 2002 through 2015, and fitieen patients operated upon due to symptomatic sacral perineurial cysts were enrolled in the study. Patients symptoms, radiographs, intraoperative findings, and clinical results were evaluated. All fifteen patients underwent microsurgical excision of the cyst. Results: There were five men and ten women included in the study, with a mean age of 31 years (range 7–60 years). Preoperative symptoms included low back pain, coccydenia, 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. Conclusion: Cyst excision is an effective and safe technique for symptomatic sacral perineurial Tarlov cysts. Careful patient selection is vital to the management and treatment of this often difficult and controversial pathology.