Glue That Pain: A Case Report and Review of Literature

Tarlov cysts are cyst like lesions of the spinal nerve roots. With a reported incidence ranging from 1 to 5%, these lesions are fairly rare, benign and often asymptomatic. When they cause neural compression they may become symptomatic with sensory, motor, bowel/bladder and sexual dysfunction. The treatment of Tarlov cysts with symptoms is controversial, ranging from conservative management and local steroid injections to a bewildering assortment of surgical options including CSF diversion procedures and advance microsurgical approaches with various ways of cyst manipulation. All these surgical modalities carry a high risk of serious complications, recurrence with the need of a redo operation and a very variable rate of symptomatic relief ranging from 38 – 100% in different series. Developing from the CT guided needle aspiration of the cyst which suffered disappointment in the form of re accumulation and heralded by earlier reports of aseptic meningitis, CT guided aspiration and subsequent filling of the cyst with fibrin glue has now emerged as Initial treatment for Tarlov cyst which is safe and effective.