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

• Published in: Case reports in women's health Vol. 25; p. e00171
• Main Authors: Hasoon, Jamal, Berger, Amnon A., Urits, Ivan, Orhurhu, Vwaire, Viswanath, Omar, Aner, Musa
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.01.2020; Elsevier
• Subjects: Chronic pain; Pelvic pain; Spinal cord stimulator; Tarlov cyst; Tarlov cyst; Spinal cord stimulator; Pelvic pain; Chronic pain
• ISSN: 2214-9112; 2214-9112
• DOI: 10.1016/j.crwh.2020.e00171

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. •Tarlov cysts are an uncommon condition that presents more often in women.•Symptomatic cysts can lead to neurologic symptoms and painful conditions including chronic pelvic pain.•Surgery for symptomatic cysts is associated with high complication rates.•Patients who develop pain after Tarlov cyst surgery may benefit from spinal cord stimulation.•Spinal cord stimulation can be beneficial for chronic pelvic pain.