Frequently Asked Questions from Tarlov Patients
What is a Tarlov cyst?
A Tarlov cyst is a dilation of the nerve root sheath or outer covering of the nerve. Cerebral spinal fluid gets trapped inside the sheath and forms a cyst. The fluid in the cyst can put pressure on the nerve inside and on the adjacent nerve roots and cause debilitating symptoms. They can occur anywhere along the spine where there are nerve roots. They are most prevalent in the sacrum or base of the spine. The cyst is the nerve and therefore cannot be cut out.
What symptoms do Tarlov or meningeal cyst patients have?
Symptoms can vary depending on the location of the cysts.
- Sacral or tail bone pain or pressure
- Pain with sitting. May feel like you are sitting on a rock or an object
- Avoidance of sitting type activity
- Pain with standing
- Pain in the legs and feet especially in the back of the thighs
- Leg weakness or numbness
- Bowel or bladder or sexual disfunction
- Vaginal, rectal, pelvic and/or abdominal pain
- Pain with sexual intercourse
- Pain or numbness in the buttocks or between the legs
- Headaches
- Symptoms made better by lying down
What additional tests can I expect will be needed before determining if I am a surgical candidate?
Some patients will need a dedicated MRI of the sacrum or flexion/extension x-rays of the lumbar spine to look for instability.
Do I have to notify my insurance company to get approval for my surgery?
Our office will do any necessary pre-authorization and contact you if there is anything you must do.
At what facility will the procedure be performed?
Surgery is scheduled either at Research Medical Center in Kansas City, Missouri or Heartland Specialty Hospital in Overland Park, Kansas. Patient needs and insurance coverage will determine the location.
How many days will I be in the hospital?
Generally three to four days.
Can a family member stay with me in the hospital?
Yes
How long will I need to stay in Kansas City after my surgery?
Five to seven days.
What is a typical scenario for being in Kansas City for surgery?
For example if your surgery is planned for a Tuesday this is a typical day by day plan. Travel to Kansas City on Sunday, meet Dr. Feigenbaum on Monday and do any pre-admission appointments at the hospital, have surgery on Tuesday, be discharged to the hotel on Friday and be seen in the office for a post operative appointment on Wednesday. If you are doing very well it may be possible to move your appointment to Monday. You can plan to travel home after your appointment or the day after.
What follow up is done after the surgery?
Patients are seen in the office one week after surgery if they are from out of town. Local patients are seen at 3 weeks, 3 months, and one and two years after surgery. Your post operative appointment is mostly with Debbie West RNFA. An MRI is done at 3 months and one and two years after surgery. Post operative surveys or questionnaires are filled out by patients at 3 and 6 months and one and two years after the surgery. Out of town patients send in the surveys and MRI's for review by Dr. Feigenbaum.
How are the cysts removed?
These uniques cysts are the nerves and therefore are not removed but rather opened, explored and treated under an operating microscope while the nerves are continuously monitored. For other types of cysts such as a meningeal diverticulum it is possible to resect the cyst as long as there are no nerves attached.
What is the plate made of that is placed over where the bone was?
The plate looks like a clear plastic mesh and is made of a polymer called poly L-lactide-co-glycolide. Over a few years is breaks down to water and your body will absorb it. Over time your body will form a tough scar on top of where the plate used to be.
What can I do to enhance my recovery from surgery?
While the recovery can be a long one and very different than other types of surgery there are some things you can do to make it the best possible recovery.
- Follow all your post-operative instructions
- Do not smoke
- Maintain a good support system of family and friends
- Follow your restrictions
- Have a positive outlook and have a motivation to get better
- Eat a healthy balanced diet to obtain proper nutrition
- Maintain a healthy weight
- Don't spend too much time focusing or talking about your pain or symptoms
- Have realistic expectations and be patient with yourself and the recovery
- Walk daily as you tolerate
I have trouble sitting, can you recommend a seat cushion?
We provide a cushion to our patients during their visit in our office that can be purchased on line. It is called a “Tush-Cush.” The “car-cush” size is quite ideal. It is available at tushcush.com or amazon.com.
How many Tarlov/meningeal cyst surgeries has Dr. Feigenbaum done?
Dr. Feigenbaum has treated over 375 Tarlov and meningeal cyst patients.
