Department of Neurosurgery, Pomeranian Medical University Hospital No. 1, Szczecin, Poland.
Surg Radiol Anat. 2021 Jun;43(6):855-863. doi: 10.1007/s00276-020-02644-y. Epub 2021 Jan 16.
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.
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.
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). 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.
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.
脊柱周围神经鞘膜 Tarlov 囊肿（TCs）被认为是偶发发现，偶尔可能对神经根施加压力，并与患者的症状相对应。本荟萃分析的目的是提供 TCs 的全球发病率和特征（位置、大小和形状）。
根据 PRISMA 清单，两位作者通过两个作者对报告 TCs 发病率和形态特征（位置、大小和形状）的所有主要数据库进行了搜索。应用解剖质量评估工具评估偏倚风险。采用随机效应模型进行荟萃分析。计划进行区域分布、性别、骶骨水平、年龄、与症状的对应关系和持续性生殖器唤醒障碍（PGAD）的亚组分析。
纳入了 22 项 3 级证据的放射学研究，涉及 13266 名受试者。TCs 的全球总患病率为 4.18%（95%CI 2.47-6.30）。平均聚合矢状直径为 11.86 毫米（95%CI 10.78-12.93）。骶骨囊肿明显优于其他节段。在骶骨中，S2 水平最常见（46.7%[95%CI 29.4-60.5]）。从地理位置上看，发病率最高的是欧洲（6.07%[95%CI 1.49-13.00]），其次是北美（3.82%[95%CI 0.49-9.44]）和亚洲（3.33%[95%CI 1.52-5.75]）。TCs 在女性中的发病率高于男性（5.84%比 3.03%，p<0.001，同质性检验，χ）。患有 PGAD 的受试者发病率为 37.87%（95%CI 2.45-81.75）。儿科人群中的 TCs 很少见-0.53%（95%CI 0.02-1.51）。15.59%的 TCs 与症状相对应。
脊柱周围神经鞘膜（Tarlov）囊肿在人群中占少数。骶骨 S2 水平最常受影响。女性患病率较高。不到五分之一的 TCs 与症状相对应。需要更高证据水平的研究来证实这些结果。PGAD 中假定的高发病率需要在病例对照研究中进行风险比计算以确认。
