Can patients with symptomatic Tarlov cysts be differentiated from patients with specific low back pain based on comprehensive history taking?
| Autor: | Marie-Laure Willaert, Charlotte Vereecke, Greet Vansant, Maria Hulens, Frans Bruyninckx, Wim Dankaerts, Ricky Rasschaert |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Tarlov cyst Non-specific low back pain Hydrostatic pressure Population Diagnosis Differential 03 medical and health sciences 0302 clinical medicine medicine Humans Fecal incontinence 030212 general & internal medicine Medical History Taking education Ischialgia Sciatica education.field_of_study Perineal pain Electromyography business.industry Middle Aged medicine.disease Magnetic Resonance Imaging Low back pain Tarlov Cysts Surgery Lumbosacral plexus Tarlov cysts Female Neurology (clinical) medicine.symptom business Low Back Pain 030217 neurology & neurosurgery |
| Zdroj: | Acta Neurochirurgica. 160:839-844 |
| ISSN: | 0942-0940 0001-6268 |
| DOI: | 10.1007/s00701-018-3494-z |
| Popis: | Background Tarlov cysts (TCs) are expanded nerve root sheaths that occur near the dorsal root ganglion and result from increased intraspinal hydrostatic pressure. TCs most frequently affect the lumbosacral plexus and therefore may cause specific symptoms such as perineal pain and neurogenic bladder, bowel, and sphincter problems. It has been estimated that 1% of the population has symptomatic Tarlov cysts (STCs). However, STCs appear to be underdiagnosed, with the pain reported by patients commonly attributed to degenerative alterations seen on MRI. The aim of the present study is to investigate the utility of a comprehensive questionnaire for use by physicians in establishing the diagnosis of STCs. Methods We compared questionnaire responses regarding patient history between 33 patients diagnosed with symptomatic TCs and 42 patients with chronic low back pain and sciatica due to disc problems or degenerative or inflammatory disorders. The diagnosis of STCs was confirmed using nerve conduction studies (NCS) and electromyography (EMG) of the sacral myotomes by an expert neurophysiologist. Results The questionnaire responses revealed specific differences in perineal symptoms (perineal pain, dyspareunia,coccygodynia), bowel symptoms (constipation, diarrhea), bladder symptoms (hesitation, retention, frequency), and anal sphincter problems (anal pain, mild fecal incontinence). Additionally, sitting, walking, and straining aggravated pain more frequently inSTC patients, and STC patients were more often forced to stop working and/or reduce their social activities. Conclusions Including the above-listed items in the patient history might facilitate differentiation of low back pain and sciatica due to STCs from that due to disc problems or degenerative or inflammatory disorders. ispartof: Acta Neurochirurgica vol:160 issue:4 pages:839-844 ispartof: location:Austria status: published |
| Databáze: | OpenAIRE |
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