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Elimination of the check-valve mechanism of the sacral Tarlov cyst using a rotation flap technique in a pediatric patient: technical note

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Abstract

Objective

Symptomatic Tarlov cysts in children are not sufficiently reported and treatment methods for Tarlov cysts are still controversial. The goal of this manuscript is to introduce a new variation of the surgical technique.

Methods

We performed surgery to eliminate the one-way check valve mechanism of the Tarlov cyst in a 7-year-old female who presented with urinary and fecal incontinence. A relatively large S3 nerve root cyst showed a one-way check valve on computed tomography myelography. The inlet of the check valve was enlarged with rotation flap reconstruction.

Results

Two months after surgery, the patient had established normal sphincter control. MRI performed two years later showed that the treated cyst was collapsing, and no recurrence occurred.

Conclusions

Rotation flap enlargement of the check valve inlet is a safe and efficacious option for the treatment of pediatric patients with sacral Tarlov cysts.

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Abbreviations

MRI:

magnetic resonance imaging

CT:

computed tomography

CSF:

cerebrospinal fluid

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Acknowledgments

The authors thank Sunji Asamoto, M.D. for the insightful comments and suggestions.

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Correspondence to Fumitaka Yoshioka.

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The authors declare no conflicts of interest. This report did not receive any funding from public or any commercial agencies.

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Yoshioka, F., Shimokawa, S., Masuoka, J. et al. Elimination of the check-valve mechanism of the sacral Tarlov cyst using a rotation flap technique in a pediatric patient: technical note. Childs Nerv Syst 37, 1741–1745 (2021). https://doi.org/10.1007/s00381-020-05029-z

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