Tarlov cysts are formed of the dura mater and the arachnoid around the sacral or coccygeal roots. Usually asymptomatic, they can occasionally cause clinical radicular irritation. Magnetic resonance imaging (MRI) permit to diagnose them more often, but whether they are responsible for the symptoms remains difficult. The initial treatment is conservative with conventional analgesics and physiotherapy. In case of large symptomatic cysts, with no response to initial treatment may require surgical therapy: a guided percutaneous drainage under computerized tomography (CT) control, or by an open technique that allows removal of the cyst and nerve decompression. We describe two cases in patients with symptomatic neuralgia due to entrapment of lumbosacral nerve roots. One patient treated with periradicular infiltration and another that required percutaneous drainage with good final outcome.

Tarlov cysts are formed of the dura mater and the arachnoid around the sacral or coccygeal roots. Usually asymptomatic, they can occasionally cause clinical radicular irritation. Magnetic resonance imaging (MRI) permit to diagnose them more often, but whether they are responsible for the symptoms remains difficult. The initial treatment is conservative with conventional analgesics and physiotherapy. In case of large symptomatic cysts, with no response to initial treatment may require surgical therapy: a guided percutaneous drainage under computerized tomography (CT) control, or by an open technique that allows removal of the cyst and nerve decompression. We describe two cases in patients with symptomatic neuralgia due to entrapment of lumbosacral nerve roots. One patient treated with periradicular infiltration and another that required percutaneous drainage with good final outcome.