Assessment of Neurophysiology parameters in symptomatic sacral Tarlov
Research type
Research Study
Full title
A comprehensive evaluation of the effects of sacral Tarlov cysts on pelvic neurophysiology and pelvic organ functions
IRAS ID
287553
Contact name
Jalesh Panicker
Contact email
Sponsor organisation
University College London Hospitals NHS Foundation Trust
Duration of Study in the UK
1 years, 9 months, 2 days
Research summary
Introduction
Tarlov cysts are fluid-filled sacs that generally form around nerve roots at the base of the spinal cord. They can form in several numbers in multiple regions of the spinal cord and can compress a single or multiple nerve roots. Tarlov cysts can cause debilitating pain below the waist that can spread to the buttocks, legs, and genital areas. They can also cause lower limbs weakness, bowel, bladder, or sexual dysfunction and can get worse over time. The exact prevalence of Tarlov cyst is unknown but estimated at 4.6 to 9 per cent of the adult population, most of them are women.Tarlov cysts were first described in the medical literature in 1938 but the exact cause for the formation of these cysts is not clear. There is no specific diagnostic protocol or accepted therapy for Tarlov cysts. NICE guidelines suggest open surgery to drain or remove Tarlov cysts if the pains are refractory to medical therapy or neurological function is threatened. Unfortunately, there are no neurological function tests or diagnostic protocols to assess Tarlov cysts.
Aim
A multidisciplinary approach rather than a multi-symptomatic approach for Tarlov’s cyst disease is currently not available within the NHS. We aim to combine various neurophysiology tests, MRI findings and clinical findings in Tarlov cyst patients.
This work will provide normative data for dermatomal evoked potentials in the sacral region and provide proof of principle evidence for the viability of using a neurophysiological diagnostic algorithm for the assessment of Tarlov cysts. If successful, this will provide a basis for a proposed much larger scale multi-centre study which also includes other diagnostic studies such as Urodynamic and Anorectal manometry studies.
This information could ultimately provide a working diagnostic and treatment algorithm for patients suffering from sacral Tarlov’s cysts, tailored for individual patients appropriately.Lay summary of study results: This study has identified that all sacral Tarlov cysts are not benign, but some can damage nerve roots located at the bottom of the spine, resulting in bladder, bowel and sexual dysfunction.
REC name
North East - Tyne & Wear South Research Ethics Committee
REC reference
21/NE/0194
Date of REC Opinion
25 Jan 2022
REC opinion
Further Information Favourable Opinion