HEALTH ENCYCLOPEDIA

Diseases & Conditions A - Z
powered by Talix

Perineural Cysts

What are perineural cysts?

Perineural cysts, which are also known as Tarlov cysts, are fluid-filled sacs that form on the nerve root sheath, most commonly in the sacral area of the spine. They can also occur anywhere else in the spine. They form around the roots of nerves. Perineural cysts are different from other cysts that can form in the sacrum because the nerve fibers from the spine are found within the cysts. Women are more likely than men to develop them.

A person with such cysts would likely never know it, because they almost never cause symptoms. When they do cause symptoms, however, one of the most common is pain in the lower back, buttocks, or legs. This occurs in rare cases when the cysts become enlarged with spinal fluid and press on nerves.

Because they rarely cause symptoms, perineural cysts are often not diagnosed. A doctor can determine if you have the cysts using imaging techniques. Perineural cysts are often misdiagnosed because symptoms are so rare. The cysts can be drained to provide temporary relief of symptoms. Only surgery can keep them from coming back or refilling with fluid and producing symptoms again. However, surgery should be considered only as a last resort, because it poses significant risks. Additionally, surgery is not always successful, and may leave the patient with greater problems. In rare cases, cysts that cause symptoms and are not treated will cause permanent damage to the nervous system.

Symptoms of perineural cysts

People with perineural cysts are not likely to have any symptoms. Most people who have them never know they are there. Symptoms only occur when the cysts fill up with spinal fluid and expand in size. When this happens, the enlarged cysts can compress nerves and cause other problems.

The most common symptom associated with perineural cysts is pain. The enlarged cysts can compress the sciatic nerve, causing sciatica. This condition is characterized by pain in the lower back and buttocks, and sometimes down the back of the legs. The pain can be sharp and sudden or more mild and achy. Sciatica is also often accompanied by numbness in the same areas, and muscle weakness in the feet and legs.

In severe cases where perineural cysts have enlarged, there can be a loss of bladder control, constipation, or even sexual dysfunction. Having these symptoms is possible, but very rare.

Causes of perineural cysts

The root cause of cysts in the base of the spine is unknown. But there are reasons why these cysts can grow and cause symptoms. If a person experiences some type of trauma in the back, perineural cysts can begin to fill up with fluid and cause symptoms. Types of trauma that can trigger symptoms include:

  • falls
  • injuries
  • heavy exertion

Diagnosis of perineural cysts

Because most perineural cysts cause no symptoms, they are typically never diagnosed. Your doctor can order imaging tests to identify them if you have symptoms. MRIs can show cysts. A CT scan with a dye injected into the spine can show if fluid is moving from the spine into cysts in the sacrum.

Treatments for perineural cysts

For most cases of perineural cysts, no treatment is needed. But if you have symptoms, they may need treatment to relieve pressure and discomfort. A quick fix is to drain the cysts of fluid. This can relieve symptoms immediately, but it is not a long-term treatment. The cysts usually fill up again.

The only permanent treatment for perineural cysts is to have them surgically removed. Surgery is usually recommended for serious, chronic pain, as well as bladder problems from the cysts.

Outlook

In the large majority of cases of perineural cysts, the outlook is excellent. Most people with these cysts will never have any symptoms or need any treatment. Only 1 percent of people with perineural cysts experience symptoms. For those with symptoms, aspiration and injection with a fibrin glue is helpful, at least temporarily. Surgery to remove the cysts is a dangerous procedure that carries significant risks. Neurological damage can occur in people with symptomatic cysts who do not seek treatment, but can occur with those undergoing surgical treatment as well. The risks and benefits must be discussed and weighed carefully before surgical intervention is undertaken.


Content licensed from:

Written by: Mary Ellen Ellison: Oct 25, 2017

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
health
TOOLS
Symptom Search
Enter your symptoms in our Symptom Checker to find out possible causes of your symptoms. Go.
Drug Interaction Checker
Enter any list of prescription drugs and see how they interact with each other and with other substances. Go.
Pill Identifier
Enter its color and shape information, and this tool helps you identify it. Go.
Drugs A-Z
Find information on drug interactions, side effects, and more. Go.
Advertisement

 

 

Discounts & Benefits

From companies that meet the high standards of service and quality set by AARP.

Member Benefits AT&T Wireless Cell Phone

Members save 10% on the monthly service charge of qualified AT&T wireless plans.

Member Benefit AARP Regal 2

Members pay $9.50 for Regal ePremiere Tickets purchased online.

Walgreens 1 discount membership aarp

Members earn points on select Walgreens-brand health and wellness products.

Member Benefits

Join or renew today! Members receive exclusive member benefits & affect social change.

Advertisement