A Case of an S2 Tarlov Cyst Causing S1 Radiculopathy

Symptomatic Tarlov cysts are rare.We present a case of an S2 Tarlov cyst causing severe S1 radiculopathy.A 37-year-old male presented with intractable pain over the right S1 dermatomal distribution.MRI revealed a right S2 Tarlov cyst that slightly compressed the adjacent S1 nerve root.His pain could not be controlled with medication.He underwent right-sided laminectomy at the S1 and S2 levels.The right S1 nerve root was found to be compressed by the right S2 Tarlov cyst.The right S2 Tarlov cyst wall was carefully incised and re-sutured to reduce the cyst size.This procedure relieved the compression of the S1 nerve root by the cyst.Postoperatively, the lower limb pain disappeared.One month later, his lower limb pain recurred, but it was manageable with medication, and there was no further worsening.The patient has been stable with reduced size of the cyst for two years.This case highlights that Tarlov cysts can cause pain in dermatomal distributions different from their involved nerve roots.