Non-surgical treatment for Tarlov cysts

Aspiration with Fibrin Glue Injection

Aspiration means to remove fluid with a needle. An interventional neuroradiologist can aspirate the cerebrospinal fluid (CSF) from cysts using a computed tomography (CT) guided needle. This may temporarily relieve symptoms, but eventually the cysts will refill and the symptoms will recur usually within hours or days. So to keep the cyst from refilling with CSF, the interventional neuroradiologist also injects a sealant called fibrin to block the neck of the cyst.

Benefits

This procedure is less invasive than surgery and has a shorter recovery. Some patients have found immediate relief, while others have reported a delayed benefit from the procedure when the nerve irritation has subsided. After the procedure, there have been reported outcomes of both short term relief, as well as longer term relief.

Risks

Anytime you place a needle into a Tarlov cyst or nerve root cyst, there is a risk of causing harm to the nerve fibers inside the cyst wall. The needle can hit the nerve fibers or hit a blood vessel and cause bleeding.

This procedure is associated with spinal fluid leakage and an increased rate of cysts reoccuring. There are risks of aseptic meningitis. Also, it takes some time for the glue to set up and if the amount of spinal fluid is simply replaced by the fibrin glue then the nerve does not become fully decompressed.