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If You Have Been Referred with a Tarlov Cyst

You have recently been referred or contacted me concerning your diagnosis of Tarlov cyst.  In order to make a general assessment of your situation it will be necessary to have complete records from the physicians who are currently caring for you and copies of the actual studies you have had done which demonstrate the Tarlov cysts.  Reports of imaging studies will not be adequate for us to review.  Films are preferable.   CD’s are often not readable, but if only CD’s are available they will be satisfactory.

I will review the records and films before your visit.  We can decide if the cysts are likely to be symptomatic, and determine if treatment may be needed.  We can also determine the need for further testing.  The process may take several weeks and will not be speeded by telephone calls.  Final decisions about diagnosis and therapy will be made only after your outpatient visit.

I cannot offer any opinions concerning the management of an individual patient until that patient is seen personally.  However, I can give general information about our experience with the cysts to date. 

If it appears that your cyst is potentially treatable we can make an appointment for you to be seen.  When you are seen I’ll review available films and may send them to neuro-radiology for review.  If you do not live in our immediate area we can try to schedule needed procedures tentatively in advance, but only if your insurance carrier gives approval.

This means you may have a time reserved for aspiration and injection of your cysts, if needed.  The fact these times are reserved does not mean these procedures will be done.  These are tentatively scheduled, only if we have prior approval.  The final decisions will be made only after you are seen.  You must obtain the insurance approval before any procedure is scheduled, even tentatively.  If you want these scheduled on your first visit, tell my office immediately when you receive an appointment and proceed to obtain approval before your visit.  Otherwise we cannot perform  any procedures on your first visit, even if indicated.

Let me repeat, these prescheduled procedures are tentative only, and final decisions will be made with you in the course of your outpatient visit.  You can always decline any recommended procedure at the end of that visit.  Please read all the material on the site to be sure you understand our current management options.

The web material contains a summary of our current understanding of sacral cysts and the treatment options which are available.  Please come prepared with questions to be discussed when you are seen in the clinic.  We will proceed only when you verify in writing that all your questions have been answered

Prior to your visit I cannot answer any specific questions related to your care.  Repeated telephone calls and e-mails cannot be answered and only decrease our ability to serve patients.  Organize your questions so they can be answered during your visit or make a telephone appointment in my weekly telephone clinic for more information.

For patients who are suitable candidates, aspiration and fibrin glue injection is our current procedure of choice.  If surgery is recommended, an appropriate referral can be made.

Diagnostic nerve blocks may help decide if treatment is recommended.

There are a small number of physicians who have shown an interest in these procedures in the United States and abroad.  The demand from patients is great and the numbers of interested physicians is small, so the waiting list is significant.  If our resources are not satisfactory for your needs, or our approaches do not meet your expectations, you may go to the Tarlov Cyst Disease Foundation website for other choices.