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Case Rep Womens Health. 2020 Jan 11;25:e00171. doi: 10.1016/j.crwh.2020.e00171. eCollection 2020 Jan.

Spinal cord stimulation for the treatment of chronic pelvic pain after Tarlov cyst surgery in a 66-year-old woman: A case report.

Author information

1
Beth Israel Deaconess Medical Center, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, United States of America.
2
Massachusetts General Hospital, Department of Anesthesia, Critical Care, and Pain Medicine, Harvard Medical School, Boston, MA, United States of America.
3
Valley Anesthesiology and Pain Consultants - Envision Physician Services, Phoenix, AZ, United States of America.
4
University of Arizona College of Medicine - Phoenix, Department of Anesthesiology, Phoenix, AZ, United States of America.
5
Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE, United States of America.

Abstract

Tarlov cysts are extradural meningeal cysts with collections of cerebrospinal fluid within the nerve sheath. These cysts are uncommon but tend to present more often in women. Symptomatic Tarlov cysts can lead to a variety of neurologic symptoms and painful conditions, including chronic pelvic pain. There is no consensus regarding the best treatment for symptomatic cysts. Surgical management has high rates of complication, including chronic pain, but better long-term results for symptom and cyst resolution. We describe a patient who developed worsening pelvic pain and lumbar radiculopathy after surgical management of her Tarlov cysts. Medication failed to relieve the pain, as did a variety of other procedures, before the patient ultimately received significant pain relief from high-frequency spinal cord stimulation. This case may provide guidance for physicians when managing patients suffering from symptomatic Tarlov cysts, or worsening pain symptoms after surgical management of these cysts.

KEYWORDS:

Chronic pain; Pelvic pain; Spinal cord stimulator; Tarlov cyst

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