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

• Main Authors: Jamal Hasoon, Amnon A. Berger, Ivan Urits, Vwaire Orhurhu, Omar Viswanath, Musa Aner
• Format: Article
• Language: English
• Published: Elsevier 2020-01-01
• Series: Case Reports in Women's Health
• Online Access: http://www.sciencedirect.com/science/article/pii/S2214911220300011

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: Pelvic pain, Chronic pain, Tarlov cyst, Spinal cord stimulator