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Tarlov Cysts

Apex Spine and Neurosurgery

Neurosurgery & Minimally Invasive Spine Surgery located in Roswell & Bethlehem, GA

Tarlov cysts that are too small to cause symptoms affect 5-9% of the general population. However, large cysts that cause pain are rare and easy to misdiagnose if your doctor doesn’t have experience with Tarlov cysts. The physicians at Apex Spine and Neurosurgery have years of experience diagnosing and treating these spinal cysts, helping patients overcome the chronic pain and restoring their overall health. To schedule an appointment, call one of the offices in Roswell, Alpharetta, or Bethlehem, Georgia, or use the online booking feature.

Tarlov Cysts Q & A

What are Tarlov cysts?

Tarlov cysts, also called perineural cysts and sacral nerve root cysts, are tiny sacs that are filled with cerebrospinal fluid and develop on nerve roots in your spine. They can occur anywhere along your spine, but they’re most often found in the sacrum, which is the triangular-shaped bone at the base of your spine.

Though there are several theories, the exact cause of Tarlov cysts remains unknown. Small cysts are more likely to enlarge and cause symptoms if you suffer a traumatic injury and after childbirth or having an epidural injection.

What symptoms develop due to Tarlov Cysts?

As long as the cysts stay small, they don’t cause symptoms. As they enlarge, however, they cause a range of symptoms as they compress the nearby nerves and put more pressure on nerves found in the cysts.

You may experience:

  • Chronic pain in your lower back
  • Pain that radiates down your buttocks and your legs
  • Tingling and numbness in your legs
  • Muscle weakness in your legs
  • Loss of sensation on your skin
  • Leg pain that’s worse when walking
  • Urinary incontinence or frequency
  • Pain during urination
  • Vaginal, rectal, pelvic and abdominal pain
  • Pelvic and abdominal pain
  • Changes in sexual function including impotence


Most patients find that the pain is worse while sitting, standing, and walking. They can only get relief from the pain when lying on their side.

How are Tarlov cysts treated?

Your pain and other symptoms may improve with anti-inflammatory medications or treatments such as transcutaneous nerve stimulation (TENS). However, draining the fluid from the cyst is the primary treatment for Tarlov cysts.

Your provider at Apex Spine and Neurosurgery may drain the cyst by performing a fine needle aspiration. Using advanced imaging to guide the procedure, they insert a needle and withdraw the fluid.

The cysts gradually refill after aspiration, so your provider may also fill the space with a fibrin glue injection. However, this still may not prevent the cyst from recurring.

Surgery is another treatment option. Your provider may recommend neurosurgical techniques such as a laminectomy to decompress the nerve, a procedure to remove the cyst and/or nerve root, or microsurgery to remove the cyst and stop the flow of cerebrospinal fluid into the area.

If you develop symptoms of a Tarlov cyst, call Apex Spine and Neurosurgery, or book an appointment online.

Fax Number for both locations: (678) 963-5307