A systematic review of the efficacy of surgical intervention in the management of symptomatic Tarlov cysts: a meta-analysis.
Br J Neurosurg
; : 1-12, 2021 Mar 23.
Article
in En
| MEDLINE
| ID: mdl-33754918
ABSTRACT
Introduction:
Tarlov cysts (TC) are sacral perineural cysts that are often found incidentally during spinal imaging. In a small fraction, symptomatic TC can cause pain, bowel, bladder and/or sexual dysfunction, as well as motor and sensory deficits. While many surgeons regard TCs as a non-operative entity, there have been suggestions that operative intervention in carefully selected symptomatic patients may be beneficial. The aim of this meta-analysis is to identify whether surgical treatment for symptomatic TCs is beneficial with an acceptable complication profile.Materials andmethods:
The authors conducted a systematic outcome analysis of symptomatic TCs treated either with surgery or conservatively managed.Results:
Sixteen studies (N = 238) met the inclusion criteria for final meta-analysis. The literature search was performed using PubMed, Ovid MEDLINE, CINAHL, and EMBASE databases up to September 2017 and with an updated search in April 2019. The post-operative complication rate in patients undergoing surgical intervention was 16.9 (11.8 to 22.7) and cyst recurrence was 8.5 (3.5 to 15.4). When a complication occurred, the most frequent complication of surgical intervention was the development of a surgical site infection and/or CSF leak. Of the 15 studies reporting long-term follow-up, 81.0 (74.0-88.0) of patients remained symptom-free for more than 1 year (Mean 27.5 months, SD = 11.5).Conclusion:
We rigorously analyse the efficacy of open surgical decompression and repair of symptomatic TCs and corroborate the findings of sustained long-term resolution of symptoms.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Type of study:
Diagnostic_studies
/
Prognostic_studies
/
Systematic_reviews
Language:
En
Journal:
Br J Neurosurg
Journal subject:
NEUROCIRURGIA
Year:
2021
Type:
Article
Affiliation country:
Canada