Symptomatic Tarlov cyst and electroacupuncture: More studies required

Tarlov cysts, which develop between the endoneurium and perineurium, are perineural cysts that are defined as cerebrospinal fluid (CSF)-filled saccular lesions commonly located in the extradural space of the sacral spinal canal[1]. They are rare, showing up in 1.5% to 4.6% of patients receiving magnetic resonance imaging (MRI) for their lumbosacral symptoms, and only 1% or less of Tarlov cysts are considered to be symptomatic[2,3].Clinical manifestation of symptomatic Tarlov cyst is non-specific and can mimic other spinal disorders: localised pain, radiculopathy, weakness, sensory disturbance, and bladder and bowel dysfunction[1,4,5]. Although surgical interventions are proven to be effective for treating Tarlov cyst[1,4–8], a conservative approach is clinically preferred to avoid invasive surgery. Some clinicians reported good results with the use of steroid therapy[9,10]. To the best of my knowledge, this case report is the first of its kind to use a medical acupuncture approach to manage this condition.