Global incidence of spinal perineural Tarlov’s cysts and their morphological characteristics: a meta-analysis of 13,266 subjects
Background Spinal perineural Tarlov’s cysts (TCs) are considered incidental findings that occasionally might exert pressure upon nerve roots and correspond with patients’ signs and symptoms. Purpose of this meta-analysis is to deliver global incidence and characteristics (location, size, and shape)...
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| Veröffentlicht in: | Surgical and radiologic anatomy (English ed.) 2021-06, Vol.43 (6), p.855-863 |
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| description | Background
Spinal perineural Tarlov’s cysts (TCs) are considered incidental findings that occasionally might exert pressure upon nerve roots and correspond with patients’ signs and symptoms. Purpose of this meta-analysis is to deliver global incidence and characteristics (location, size, and shape) of TCs.
Methods
Following PRISMA checklist, all major databases were searched by two authors for radiologic studies reporting incidence and morphologic features (location, size, and shape) of TCs. Anatomical Quality Assessment tool was applied for risk of bias evaluation. Meta-analysis of random-effects model was employed. Subgroup analysis for regional distribution, gender, sacral levels, age, correspondence with symptoms, and persistent genital arousal disorder (PGAD) were planned ahead.
Results
22 radiologic studies of level 3 evidence involving 13,266 subjects were included. Global pooled prevalence of TCs was 4.18% (95% CI 2.47–6.30). Mean pooled sagittal diameter was 11.86 mm (95% CI 10.78–12.93). Sacral cysts strongly prevailed over the other segments. Of the sacral, S2 level was the most common (46.7% [95% CI 29.4–60.5]). Geographically, the highest incidence was found in Europe (6.07% [95% CI 1.49–13.00]), followed by North America (3.82% [95% CI 0.49–9.44]), and Asia (3.33% [95% CI 1.52–5.75]). TCs were more common in women than in men (5.84% vs 3.03%,
p
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| doi_str_mv | 10.1007/s00276-020-02644-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8164596</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2478595957</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-64efdcb11109184b1775a6b9e3ef35f1cea19925ca7ac7c652287b8a130e10a03</originalsourceid><addsrcrecordid>eNp9kc2KFDEQx4Mo7rj6Ah4k4MWDrfnsdDwIsugqLHhZzyGdqZ7J0N0ZU90LfZN9i309n8SMs64fBwkhRepX_1TlT8hTzl5xxsxrZEyYumKClV0rVS33yIoLY6tGc3OfrJiVrOJMNifkEeKOMaY5bx6SEymVFpbpFbk-71PrexrHENcwBqCpo7iPY7nbQ44jzLmElz736er7txukYcEJqR_XdNpCzHRIeb9NfdrEUMCw9dmHqVTiFAO-oZ4OMPnKF8EFIx7kuXwp6pri3O4gTPiYPOh8j_Dk9jwlXz68vzz7WF18Pv909u6iCsqoqaoVdOvQcs6Z5Y1quTHa160FCZ3UHQ_gubVCB298MKHWQjSmbTyXDDjzTJ6St0fd_dwOsA4wTmU0t89x8HlxyUf3d2aMW7dJV67htdK2LgIvbgVy-joDTm6IGKDv_QhpRieUabQtyxT0-T_oLs25_EGhtJTWKmMPHYkjFXJCzNDdNcOZO1jsjha7YrH7abFbStGzP8e4K_nlaQHkEcCSGjeQf7_9H9kfli21KA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2533994790</pqid></control><display><type>article</type><title>Global incidence of spinal perineural Tarlov’s cysts and their morphological characteristics: a meta-analysis of 13,266 subjects</title><source>SpringerLink Journals - AutoHoldings</source><creator>Klepinowski, Tomasz ; Orbik, Wojciech ; Sagan, Leszek</creator><creatorcontrib>Klepinowski, Tomasz ; Orbik, Wojciech ; Sagan, Leszek</creatorcontrib><description>Background
Spinal perineural Tarlov’s cysts (TCs) are considered incidental findings that occasionally might exert pressure upon nerve roots and correspond with patients’ signs and symptoms. Purpose of this meta-analysis is to deliver global incidence and characteristics (location, size, and shape) of TCs.
Methods
Following PRISMA checklist, all major databases were searched by two authors for radiologic studies reporting incidence and morphologic features (location, size, and shape) of TCs. Anatomical Quality Assessment tool was applied for risk of bias evaluation. Meta-analysis of random-effects model was employed. Subgroup analysis for regional distribution, gender, sacral levels, age, correspondence with symptoms, and persistent genital arousal disorder (PGAD) were planned ahead.
Results
22 radiologic studies of level 3 evidence involving 13,266 subjects were included. Global pooled prevalence of TCs was 4.18% (95% CI 2.47–6.30). Mean pooled sagittal diameter was 11.86 mm (95% CI 10.78–12.93). Sacral cysts strongly prevailed over the other segments. Of the sacral, S2 level was the most common (46.7% [95% CI 29.4–60.5]). Geographically, the highest incidence was found in Europe (6.07% [95% CI 1.49–13.00]), followed by North America (3.82% [95% CI 0.49–9.44]), and Asia (3.33% [95% CI 1.52–5.75]). TCs were more common in women than in men (5.84% vs 3.03%,
p
< 0.001, test of homogeneity,
χ
2
). Subjects with PGAD had incidence of 37.87% (95% CI 2.45–81.75). TCs in pediatric population are rare—0.53% (95% CI 0.02–1.51). 15.59% of TCs corresponded with symptoms.
Conclusions
Spinal perineural (Tarlov) cysts are found in a minority of population. S2 level of the sacral bone is affected most frequently. There is female predominance. Correspondence with symptoms is seen in less than one-fifth of TCs. Studies with stronger evidence level are needed to corroborate the results. The purported high incidence in PGAD requires confirmation in case–control studies for the risk-ratio calculation.</description><identifier>ISSN: 0930-1038</identifier><identifier>EISSN: 1279-8517</identifier><identifier>DOI: 10.1007/s00276-020-02644-y</identifier><identifier>PMID: 33452905</identifier><language>eng</language><publisher>Paris: Springer Paris</publisher><subject>Age composition ; Anatomy ; Arousal ; Cysts ; Imaging ; Medicine ; Medicine & Public Health ; Meta-analysis ; Original ; Original Article ; Orthopedics ; Physical characteristics ; Quality control ; Radiology ; Sacrum ; Surgery</subject><ispartof>Surgical and radiologic anatomy (English ed.), 2021-06, Vol.43 (6), p.855-863</ispartof><rights>The Author(s) 2021</rights><rights>The Author(s) 2021. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-64efdcb11109184b1775a6b9e3ef35f1cea19925ca7ac7c652287b8a130e10a03</citedby><cites>FETCH-LOGICAL-c474t-64efdcb11109184b1775a6b9e3ef35f1cea19925ca7ac7c652287b8a130e10a03</cites><orcidid>0000-0003-4806-2094</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00276-020-02644-y$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00276-020-02644-y$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,315,781,785,886,27926,27927,41490,42559,51321</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33452905$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Klepinowski, Tomasz</creatorcontrib><creatorcontrib>Orbik, Wojciech</creatorcontrib><creatorcontrib>Sagan, Leszek</creatorcontrib><title>Global incidence of spinal perineural Tarlov’s cysts and their morphological characteristics: a meta-analysis of 13,266 subjects</title><title>Surgical and radiologic anatomy (English ed.)</title><addtitle>Surg Radiol Anat</addtitle><addtitle>Surg Radiol Anat</addtitle><description>Background
Spinal perineural Tarlov’s cysts (TCs) are considered incidental findings that occasionally might exert pressure upon nerve roots and correspond with patients’ signs and symptoms. Purpose of this meta-analysis is to deliver global incidence and characteristics (location, size, and shape) of TCs.
Methods
Following PRISMA checklist, all major databases were searched by two authors for radiologic studies reporting incidence and morphologic features (location, size, and shape) of TCs. Anatomical Quality Assessment tool was applied for risk of bias evaluation. Meta-analysis of random-effects model was employed. Subgroup analysis for regional distribution, gender, sacral levels, age, correspondence with symptoms, and persistent genital arousal disorder (PGAD) were planned ahead.
Results
22 radiologic studies of level 3 evidence involving 13,266 subjects were included. Global pooled prevalence of TCs was 4.18% (95% CI 2.47–6.30). Mean pooled sagittal diameter was 11.86 mm (95% CI 10.78–12.93). Sacral cysts strongly prevailed over the other segments. Of the sacral, S2 level was the most common (46.7% [95% CI 29.4–60.5]). Geographically, the highest incidence was found in Europe (6.07% [95% CI 1.49–13.00]), followed by North America (3.82% [95% CI 0.49–9.44]), and Asia (3.33% [95% CI 1.52–5.75]). TCs were more common in women than in men (5.84% vs 3.03%,
p
< 0.001, test of homogeneity,
χ
2
). Subjects with PGAD had incidence of 37.87% (95% CI 2.45–81.75). TCs in pediatric population are rare—0.53% (95% CI 0.02–1.51). 15.59% of TCs corresponded with symptoms.
Conclusions
Spinal perineural (Tarlov) cysts are found in a minority of population. S2 level of the sacral bone is affected most frequently. There is female predominance. Correspondence with symptoms is seen in less than one-fifth of TCs. Studies with stronger evidence level are needed to corroborate the results. The purported high incidence in PGAD requires confirmation in case–control studies for the risk-ratio calculation.</description><subject>Age composition</subject><subject>Anatomy</subject><subject>Arousal</subject><subject>Cysts</subject><subject>Imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Meta-analysis</subject><subject>Original</subject><subject>Original Article</subject><subject>Orthopedics</subject><subject>Physical characteristics</subject><subject>Quality control</subject><subject>Radiology</subject><subject>Sacrum</subject><subject>Surgery</subject><issn>0930-1038</issn><issn>1279-8517</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp9kc2KFDEQx4Mo7rj6Ah4k4MWDrfnsdDwIsugqLHhZzyGdqZ7J0N0ZU90LfZN9i309n8SMs64fBwkhRepX_1TlT8hTzl5xxsxrZEyYumKClV0rVS33yIoLY6tGc3OfrJiVrOJMNifkEeKOMaY5bx6SEymVFpbpFbk-71PrexrHENcwBqCpo7iPY7nbQ44jzLmElz736er7txukYcEJqR_XdNpCzHRIeb9NfdrEUMCw9dmHqVTiFAO-oZ4OMPnKF8EFIx7kuXwp6pri3O4gTPiYPOh8j_Dk9jwlXz68vzz7WF18Pv909u6iCsqoqaoVdOvQcs6Z5Y1quTHa160FCZ3UHQ_gubVCB298MKHWQjSmbTyXDDjzTJ6St0fd_dwOsA4wTmU0t89x8HlxyUf3d2aMW7dJV67htdK2LgIvbgVy-joDTm6IGKDv_QhpRieUabQtyxT0-T_oLs25_EGhtJTWKmMPHYkjFXJCzNDdNcOZO1jsjha7YrH7abFbStGzP8e4K_nlaQHkEcCSGjeQf7_9H9kfli21KA</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>Klepinowski, Tomasz</creator><creator>Orbik, Wojciech</creator><creator>Sagan, Leszek</creator><general>Springer Paris</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-4806-2094</orcidid></search><sort><creationdate>20210601</creationdate><title>Global incidence of spinal perineural Tarlov’s cysts and their morphological characteristics: a meta-analysis of 13,266 subjects</title><author>Klepinowski, Tomasz ; Orbik, Wojciech ; Sagan, Leszek</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-64efdcb11109184b1775a6b9e3ef35f1cea19925ca7ac7c652287b8a130e10a03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Age composition</topic><topic>Anatomy</topic><topic>Arousal</topic><topic>Cysts</topic><topic>Imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Meta-analysis</topic><topic>Original</topic><topic>Original Article</topic><topic>Orthopedics</topic><topic>Physical characteristics</topic><topic>Quality control</topic><topic>Radiology</topic><topic>Sacrum</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Klepinowski, Tomasz</creatorcontrib><creatorcontrib>Orbik, Wojciech</creatorcontrib><creatorcontrib>Sagan, Leszek</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Surgical and radiologic anatomy (English ed.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Klepinowski, Tomasz</au><au>Orbik, Wojciech</au><au>Sagan, Leszek</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Global incidence of spinal perineural Tarlov’s cysts and their morphological characteristics: a meta-analysis of 13,266 subjects</atitle><jtitle>Surgical and radiologic anatomy (English ed.)</jtitle><stitle>Surg Radiol Anat</stitle><addtitle>Surg Radiol Anat</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>43</volume><issue>6</issue><spage>855</spage><epage>863</epage><pages>855-863</pages><issn>0930-1038</issn><eissn>1279-8517</eissn><abstract>Background
Spinal perineural Tarlov’s cysts (TCs) are considered incidental findings that occasionally might exert pressure upon nerve roots and correspond with patients’ signs and symptoms. Purpose of this meta-analysis is to deliver global incidence and characteristics (location, size, and shape) of TCs.
Methods
Following PRISMA checklist, all major databases were searched by two authors for radiologic studies reporting incidence and morphologic features (location, size, and shape) of TCs. Anatomical Quality Assessment tool was applied for risk of bias evaluation. Meta-analysis of random-effects model was employed. Subgroup analysis for regional distribution, gender, sacral levels, age, correspondence with symptoms, and persistent genital arousal disorder (PGAD) were planned ahead.
Results
22 radiologic studies of level 3 evidence involving 13,266 subjects were included. Global pooled prevalence of TCs was 4.18% (95% CI 2.47–6.30). Mean pooled sagittal diameter was 11.86 mm (95% CI 10.78–12.93). Sacral cysts strongly prevailed over the other segments. Of the sacral, S2 level was the most common (46.7% [95% CI 29.4–60.5]). Geographically, the highest incidence was found in Europe (6.07% [95% CI 1.49–13.00]), followed by North America (3.82% [95% CI 0.49–9.44]), and Asia (3.33% [95% CI 1.52–5.75]). TCs were more common in women than in men (5.84% vs 3.03%,
p
< 0.001, test of homogeneity,
χ
2
). Subjects with PGAD had incidence of 37.87% (95% CI 2.45–81.75). TCs in pediatric population are rare—0.53% (95% CI 0.02–1.51). 15.59% of TCs corresponded with symptoms.
Conclusions
Spinal perineural (Tarlov) cysts are found in a minority of population. S2 level of the sacral bone is affected most frequently. There is female predominance. Correspondence with symptoms is seen in less than one-fifth of TCs. Studies with stronger evidence level are needed to corroborate the results. The purported high incidence in PGAD requires confirmation in case–control studies for the risk-ratio calculation.</abstract><cop>Paris</cop><pub>Springer Paris</pub><pmid>33452905</pmid><doi>10.1007/s00276-020-02644-y</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-4806-2094</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Age composition Anatomy Arousal Cysts Imaging Medicine Medicine & Public Health Meta-analysis Original Original Article Orthopedics Physical characteristics Quality control Radiology Sacrum Surgery |
| title | Global incidence of spinal perineural Tarlov’s cysts and their morphological characteristics: a meta-analysis of 13,266 subjects |
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