Perineural or Tarlov cysts

Posted by jenapower @jenapower, May 23, 2017

Hi, my name is Jennifer. I have commented on here before but I've never started a post. I have been told that I have fibromyalgia for a long time, I also have had a number of accidents with many broken bones and surgeries to put things back together. All of this has resulted in chronic pain, most of it is down my head/back/pelvis/spine and legs. In an effort to try to see more my doctor did a lumbar and pelvic MRI last week. Turns out I have a cyst on my spine called a perineural or Tarlov cyst. It's basically assistant starts at the nerve root and herniates out filling with spinal fluid. I guess there's like a leak from your spine to this cyst but the system itself is made up of nerves. It's the best of my understanding at this point. Mine is at the S2 location, and can cause pain from your back down your bottom and down your legs and includes some pretty severe headaches because it's upsetting the pressure of the spinal fluid around the brain. Again this is the best of my understanding of what I've been told. It certainly explains a lot of my symptoms that have been contributed to fibromyalgia and broken bones. Again they're not really sure what causes them but they think trauma in that area could be a contributor. I just wondered if anyone else had heard of this or experienced it. It is considered rare, i've come to find out there are only two doctors in the United States to do surgery on it. One of them that's all he does and he actually goes to other countries to help people that don't have access to a doctor that is experienced in this surgery. It's a long recovery and pretty scary surgery because they're messing with your new or nerve root I don't want to think about what the bad consequences could be although I know I have to. I think I've gotten to a point where I'm pretty much flat on my back every day and it's no life, so I'm actually happy to have an answer. If anybody else knows anything about this I would love to hear it or has any experience with the surgery.
Thank you, Jennifer

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@mar2a

@arlenejc I'll keep that in mind for the future, but this is a cyst that could be pressing against a nerve and causing damage. I want to know if that's the case. @summertime4 Yes! And since my doctor said I might eventually need epidural injections, and since neurologists apparently do those, I'm really considering going to one for at least a consult.

I did some more research and apparently these cysts are asymptomatic, but occasionally can be symptomatic and cause exactly the pain I'm having. I'd hate to just ignore this and find out a few years from now that I have permanent nerve damage. I can ignore pain, to some degree, but I'm not going to be able to ignore loss of function.

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That is wise and just keep what I told you in case you want to try that path in the future. Good luck to you.

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Thank you for the term Tarlov. I have myoclonic dystonic leg jerks. Since they may be from the brain or spine, additional information is appreciated. No one seems to know much about mine. any time I am drowsy, any time, i get lightning bolt leg jerks that lift my ankle knee a foot or two.O take Gapedentine and Ropinrole only because I was originally diagnosised with restless leg syndrome. Periodic movement disorders happen in sleep. Mine happen at the end of a nights sleep or any time in day. I see a neurologist next week. But, I am googling to be prepared. We all seem to have exotic things the Docs have to bone up on..Yes I know, see a movement specialist. Where in New Mexico.? I have the best group. I'll let you all know what they say.

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If there is anyone who has had tarlov cyst surgery and can share post surgery recovery with me I would like to share xperience I had surgery in December last year Still suffering from the neuropathy I had before the surgery.
Any experience of how long it takes for nerve recovery would be most helpful.I am desperate as there has been no improvement in my condition post surgery despite a harrowing three months of other complications like urine retention

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@anita1940

If there is anyone who has had tarlov cyst surgery and can share post surgery recovery with me I would like to share xperience I had surgery in December last year Still suffering from the neuropathy I had before the surgery.
Any experience of how long it takes for nerve recovery would be most helpful.I am desperate as there has been no improvement in my condition post surgery despite a harrowing three months of other complications like urine retention

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Hi, @anita1940, and welcome to Mayo Clinic Connect. I think it makes sense to talk to others who've had a similar surgery to "compare notes." I get it that spending a harrowing three months postsurgery with complications and then not seeing the improvements you'd hoped for from the surgery would be difficult. I had a bladder prolapse surgery that included about that long of a recovery. I would have been incredibly discouraged, having given that much of my life to that surgery, if it didn't help me in the end.

Hoping that others who've talked about tarlov cysts will have some information and thoughts for you about how things went for them after the surgery and any timeline for how long nerve recovery may have taken for them. Please meet @jenapower @bill54321 @arlenejc @qball2019 @cookiegirl.

What are your surgeon's expectations for timeline with improvements postsurgery, anita1940?

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@anita1940

If there is anyone who has had tarlov cyst surgery and can share post surgery recovery with me I would like to share xperience I had surgery in December last year Still suffering from the neuropathy I had before the surgery.
Any experience of how long it takes for nerve recovery would be most helpful.I am desperate as there has been no improvement in my condition post surgery despite a harrowing three months of other complications like urine retention

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@anita1940

Anita, I'm so sorry to hear that you haven't seen any improvement yet and are still suffering. You know, recovery is going to be different for all of us. There are numerous factors that affect the outcome of surgery. How long did you have the symptoms prior to surgery? How badly the cysts are compressing the nerves, possibly where they are located, etc. As soon as my insurance co. gives in I am going to have surgery with Dr. Feigenbaum in Dallas, TX. I'm pretty much bedridden with all these symptoms. I've been fighting them via the grievance and appeals process. May I ask who your surgeon is? I would think they should have given you post-op instructions and talked to you about the recovery process. Aside from reading about other people's experiences, I have found the info. on Dr. Feigenbaum's website to be most helpful. https://www.frankfeigenbaum.com/post-op-information/tarlovmeningeal-cyst-post-operative-instructions Unfortunately, recovery can take up to 2 years and sometimes more. This is because nerves heal and regenerate very slowly. As with any back/nerve surgery there is no way to guarantee a great recovery. You will probably never be 100% again but there should be some improvement. It seems like there are many more positive outcomes than not. Also, arachnoiditis goes hand in hand with Tarlov cysts. I found extremely valuable information at http://www.arachnoiditishope.com I urge anyone with Tarlov cysts to go to that site and do some reading. Please note that I am not a medical professional and my suggestions come purely from my experience and opinion. I wish for your recovery to start going a bit faster for you. If there are any other questions you have don't hesitate to ask. There are many members on here that have excellent advice for you. Take care!

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Thanks for your advice and guidance . The surgeon was Mr Adrian Casey and the operation was done in London
And the surgeon said it had gone off well . Despite that I have severe neuropathy and urine infections since December . Have been on antibiotics for months . Very disappointed and concerned surely this could not happen to others. Can anyone tell me if they have had surgery if this is normal.
Anita

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@anita1940

Thanks for your advice and guidance . The surgeon was Mr Adrian Casey and the operation was done in London
And the surgeon said it had gone off well . Despite that I have severe neuropathy and urine infections since December . Have been on antibiotics for months . Very disappointed and concerned surely this could not happen to others. Can anyone tell me if they have had surgery if this is normal.
Anita

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@anita1940

There are quite a few people on the Facebcook group Tarlov Cyst Society that share their surgery experiences. I was even more afraid after reading what other people said but there were plenty of people with positive experiences as well. What you need to keep in mind is that everyone is "wired" differently so the extent of the success of the surgery is individualized. No two outcomes will be the same. There are various factors to consider as well such as how long you have had symptoms and how extensive your nerve damage is prior to surgery. Also whether you do your post surgery exercises like you're supposed to. These are just a couple of the factors. Just like with any surgery that involves the spine and nerves, the outcome varies. I don't think it's fair for those that had negative experiences to blame the surgeon because there is no guarantee and this is talked about extensively prior to surgery.I went to see Dr. Feigenbaum and I asked which technique is the best, titanium or mesh. He said the decision on which to use depends on the anatomy of the cysts, locations, etc. For me, my decision is based on my own opinion of risk vs reward. I am currently basically bedridden because I can't stand, walk, or sit for more than a few minutes and I can't sit on my right butt cheek at all. I'm stuck just laying down 95% of the time. I have numerous other symptoms as well. I can't imagine things getting worse for me so I am choosing surgery but have been fighting with my insurance co. to approve it. You just need to do your own assessment and weigh it all out. Don't let someone else's negative experience interfere with your decision. I hope this helps you a little bit. Take care!

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@qball2019

@anita1940

There are quite a few people on the Facebcook group Tarlov Cyst Society that share their surgery experiences. I was even more afraid after reading what other people said but there were plenty of people with positive experiences as well. What you need to keep in mind is that everyone is "wired" differently so the extent of the success of the surgery is individualized. No two outcomes will be the same. There are various factors to consider as well such as how long you have had symptoms and how extensive your nerve damage is prior to surgery. Also whether you do your post surgery exercises like you're supposed to. These are just a couple of the factors. Just like with any surgery that involves the spine and nerves, the outcome varies. I don't think it's fair for those that had negative experiences to blame the surgeon because there is no guarantee and this is talked about extensively prior to surgery.I went to see Dr. Feigenbaum and I asked which technique is the best, titanium or mesh. He said the decision on which to use depends on the anatomy of the cysts, locations, etc. For me, my decision is based on my own opinion of risk vs reward. I am currently basically bedridden because I can't stand, walk, or sit for more than a few minutes and I can't sit on my right butt cheek at all. I'm stuck just laying down 95% of the time. I have numerous other symptoms as well. I can't imagine things getting worse for me so I am choosing surgery but have been fighting with my insurance co. to approve it. You just need to do your own assessment and weigh it all out. Don't let someone else's negative experience interfere with your decision. I hope this helps you a little bit. Take care!

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I very recently commented on a different site about a very uncommon surgery (not spinal, but 8-9 hours long) I had almost 11 years ago. If it had not worked, well, let’s just say I won’t go there. It DID work and I am fine and forever grateful. For me at that point in my life, quality of life was most important. It was the proverbial rock vs hard spot dilemma. I had MANY battles with my insurance company. I so feel your pain. Good luck with everything!

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@wisco50
"
Thank you, I sincerely appreciate that. I will fight as long as I need to. I do understand your thoughts about "where you don't want to go". I think everyone in a predicament like this has those thoughts. I will exhaust all options to avoid going there.

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@qball2019

Sorry for the extra reply but...

Do you also have issues with your bladder or bowels? I have had issues with my bladder since 2003 and lost control of my bowels in June of last year. These are both symptoms of cauda equina syndrome. It's normally an emergency for other people but if it's because of Tarlov cysts it won't be unless the doctor you have will admit that the cysts cause issues. It's really a terrible shame because there can be some serious nerve damaged caused by waiting.

I also forgot to mention that my cysts have shown up on my MRI & CT scans all the way back to 2003. Nothing was ever mentioned to me about them until last year! Also, there were only 3 cysts noted in my report but the neurosurgeon found 5 or 6 (he won't know how many for sure until he's in there) and a fatty filium. The fatty filium is also called a tethered cord which normally happens at birth but can also happen with an injury. Mine happened with the injury. Interesting thing is that he said when he releases the tethered cord it may or may not release the pain in my back. The tethered cord has never been mentioned before either so I was surprised by that one. Must be another "incidental finding". I'm finding that there are lots of those.

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I am also diagnosed with tethered cord syndrome and tarlov cyst in sacrum. Have you got your surgery done yet? I am interviewing neurosurgeons for my surgery.

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