Tarlov cysts are something I get asked about often, and the truth is the number of symptomatic ones is minuscule compared to the asymptomatic ones, which is why they are so hard to find. No one really knows why we get them. I have a theory, and it is just a theory: it has to do with a combination of genetic predisposition like weak collagen and bad luck. What happens is that when you have a state of heightened inflammation, the little tissues called trabeculae that connect the nerve roots together and organize them in three dimensional space get really thickened. A little honeycomb web develops inside the dural tube and it becomes a one way check valve. As the spinal fluid pumps in it has no way to get out, and it just gets bigger and bigger. Some of them become symptomatic probably because it activates an inflammatory process, and you go down this vicious cycle where inflammation causes more thickening of the trabeculae, more thickening causes more of a one way check valve, more pressure causes more inflammation, and so on. If you have it, it is 100% for you, so it is imperative that we go the extra mile to figure out if someone is having symptoms. One way to do that is to inject an anesthetic and a steroid through the tailbone and see if you get temporarily better. If you do, it is symptomatic and we do surgery. They are some of my happiest patients, seriously. Follow for more on spine health.
Medical Disclaimer: The information in this video is for educational purposes only and is not intended as medical advice. Surgical procedures shown may not be appropriate for all individuals. Viewing this content does not establish a physician patient relationship. Treatment decisions should be made by qualified healthcare professionals based on individual patient circumstances.
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