Balloon-assisted fistula sealing procedure for symptomatic Tarlov Cysts.

Balloon-assisted fistula sealing procedure for symptomatic Tarlov Cysts.

World Neurosurg. 2016 Jan 20;

Authors: Zheng X, Li S, Sheng H, Feng B, Zhang N, Xie C

Abstract
OBJECTIVE: Tarlov cyst is an abnormal expansion of the spinal nerve sleeve, and communicates with the subarachnoid cavity via a perineural fistula. This study is to present our experience of balloon-assisted fistula sealing procedure in treating Tarlov cyst.
METHODS: Twenty-two patients with symptomatic Tarlov cysts were surgically treated. An emulsion balloon was placed into the lumbar subarachnoid cistern through a trocar, so as to temporarily block cerebrospinal fluid flow, then the thecal sac was opened and the inlet of the fistula was sealed by suture of a muscular patch and reinforced by fibrin glue. At last the cyst wall was imbricated and the bony cavity was filled with pedicled muscle flaps.
RESULTS: Comparing the preoperative and postoperative pain scores according to visual analog scale, 2 patients were slightly improved; 18 patients were substantially improved, including 3 completely pain-free cases. Only 2 patients were unchanged in pain, and both of them were multiple cysts. As a whole, the postoperative pain score is much better than the preoperative score (2.4 vs 7.5, P<0.01). Bladder weakness was slightly improved, and bowel dysfunction was almost unchanged after operation. During follow-up, cyst recurrence was found in one patient.
CONCLUSION: The balloon-assisted fistula sealing procedure is safe and effective for Tarlov cyst, especially for the single cyst. It's a good complement to the cyst wall imbricating procedure.

PMID: 26802871 [PubMed - as supplied by publisher]

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