Prevalence of simple and complex sacral perineural Tarlov cysts in a French cohort of adults and children.
OBJECTIVE
To determine the prevalence of simple and complex sacral perineural Tarlov cysts (TCs) in a cohort of children and adults.


METHODS
Retrospective observational epidemiological study assessing 1100 consecutive sacral magnetic resonance (MR) studies, including 100 children and adolescents. All patients underwent 1.5T MR imaging with T1 and T2 weighted image acquisitions in sagittal and axial planes. All perineural cysts affecting the sacral nerve roots S1-S4 were quantitatively and qualitatively assessed.


RESULTS
Two hundred and sixty-three sacral TCs were found in 132 adult patients (13.2%), with a female predominance (68%). None was found in children. The prevalence of TCs increased with age. The average number of cysts per patient was 2.0±1.2 with a maximum of 6 cysts in a single patient. Most of the cysts (87.5%) showed a homogenous central fluid collection and a parietal course of the nerve fibers. Complex patterns were present in 33 cysts (12.5%) within which 28 cysts showed endocystic crossing of nerve fibers and 5 cysts contained internal septations. Seventy cysts (26.6%) eroded the adjacent bone and 13 cysts (4.9%) extended to the pelvis.


CONCLUSIONS
The prevalence of sacral TCs in our cohort corresponded to 13%, with a female predominance. Interestingly no TCs were found in children or adolescents (<18 years). In relation to the non-negligible percentage of complex cysts with internal septations, or endocystic crossing of nerve fibers, pre-interventional characterization of sacral TCs might help to choose an appropriate procedure in the treatment of rare symptomatic variants.
Service de radiologie B, AP-HP, centre hospitalier universitaire Cochin, faculté de médecine, université Paris Descartes, 75679 Paris, France. Electronic address: Felix.Kuhn@usz.ch.
Félix P
FP
Kuhn
Service de radiologie B, AP-HP, centre hospitalier universitaire Cochin, faculté de médecine, université Paris Descartes, 75679 Paris, France.
Sonia
S
Hammoud
Service de médecine physique and de réadaptation, AP-HP, centre hospitalier universitaire Cochin, faculté de médecine, université Paris Descartes, 75679 Paris, France; Inserm, U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), épidémiologie clinique appliquées aux maladies ostéo-articulaires (Ecamo), université Paris Descartes, 75679 Paris, France.
Marie-Martine
MM
Lefèvre-Colau
Service de médecine physique and de réadaptation, AP-HP, centre hospitalier universitaire Cochin, faculté de médecine, université Paris Descartes, 75679 Paris, France; Inserm, U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), épidémiologie clinique appliquées aux maladies ostéo-articulaires (Ecamo), université Paris Descartes, 75679 Paris, France.
Serge
S
Poiraudeau
Service de radiologie B, AP-HP, centre hospitalier universitaire Cochin, faculté de médecine, université Paris Descartes, 75679 Paris, France; Inserm, U1153 Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), épidémiologie clinique appliquées aux maladies ostéo-articulaires (Ecamo), université Paris Descartes, 75679 Paris, France.
Antoine
A
Feydy
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D012447:Sacrum / Q000000981:diagnostic imaging / Q000473:pathology; D052958:Tarlov Cysts / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D055815:Young Adult
Epidemiology; Perineural cysts; Spine; Tarlov cysts