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  • GypsyBlu
    Participant
    Post count: 1

    Dear Dr.
    2013 I had Tarlov Cyst surgery, the most painful one was on/in my coccyx. He was able to wrap and tighten it down so it shouldn’t balloon up again. I had another at 2 at S2, 1 at S3, And another around the coccyx area. A total of 5. The others he was not able to wrap. Once again I am having pain in my sacrum and coccyx. I had nerve damage prior to surgery and worse damage after. I am pretty much bed ridden because of the damage and my pain. I’m Scared to death. This surgery was so hard on me the thought of having another will bring me to tears.
    Can people have more surgery like this? I know there was a chance for more to form. The other question is, I’m finding it odd that when I have a Ménière’s fullness come ( I had surgery for that too 20 years ago). I start to get more pain in my sacrum. Is it possible I’ve got a tiny leak of csf?

    Thank you
    Gypsyblu

    Donald Corenman, MD, DC
    Moderator
    Post count: 8656

    Tarlov cysts occur due to weakness of the dural membrane. The dural sac is filled with CSF which is essentially water. If you hold a long water balloon from the tip, the bottom of the balloon will be larger than the top. This is due to the weight of water. The pressure in the bottom of the balloon is greater that the top. This causes the balloon “membrane” to stretch wider here than the top.

    This is the same principle with Tarlov cysts also known as cystic root sleeve dilations. The dural membrane stretches out and actually can cause erosion of bone in the sacrum due to this pressure.

    Commonly, these cysts are painless and are found quite commonly on an MRI as an accessory finding. If they are painful, fixing them is fraught with complications. You have to expose these cysts which means taking bone off the back of the sacrum which by itself can cause instability. Then, just like a Taylor, you have to “take in the excess” and mend the opening. Don’t forget that the sacral nerves are in this “cyst” and manipulation of these nerves can possibly damage them causing more symptoms.

    Dural leaks typically cause positional headaches so I don’t think that the Meniere’s disease is related.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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