Management of Tarlov Cysts

Initial Management Approach

The initial management approach for patients with Tarlov cysts should focus on conservative measures, as most Tarlov cysts are asymptomatic and do not require invasive intervention, according to the American College of Radiology 1
Most Tarlov cysts are asymptomatic and should be managed with observation only, as recommended by the American College of Radiology 1
Avoid unnecessary surgery, since most Tarlov cysts are asymptomatic, incidental findings should not lead to invasive procedures, as stated by the American College of Radiology 1

When considering surgery, be aware of the location of the dural tube and any potential spina bifida occulta or manifestations of dural ectasia, as inadvertent leakage of cerebrospinal fluid can lead to meningitis, according to Clinical Infectious Diseases 2
The lower sacral nerve roots (S2-S4) innervate the urinary and anal sphincters, and care must be taken in non-paraplegic patients to avoid damage to these structures during surgical intervention, as noted by Clinical Infectious Diseases 2