医院神经外科腰骶神经中心
原文：SymptomaticTarlovcystsareoftenoverlooked:tenreasonswhy-anarrativereview
作者：MiekeHulens·RickyRasschaert·FransBruyninckx·WimDankaerts·IngeborgStalmans·PeterDeMulder·GreetVansant（德国）
编译：杨敏沈霖审校：郑学胜
Abstract
Purpose:Tarlovcysts(TCs)aredilationsofnerverootsarisingfrompathologicallyincreasedhydrostaticpressure(HP)inthespinalcanal.Thereismuchcontroversyregardingwhetherthesecystsareararesourceofpainoroftenproducesymptoms.TheaimofthisreviewwastoidentifythereasonsthatsymptomaticTCs(STCs)areeasilyoverlooked.
骶管囊肿（TCs）是由于椎管内静水压力（HP）升高而引起的神经根扩张。关于这些囊肿是否是一种罕见的疼痛来源或经常产生症状，有很多争议。本文旨在找出症状性TCs（STCs）容易被忽视的原因。
Methods：Theliteraturewassearchedfordataregardingpathogenesisandsymptomatology.
查阅文献，寻找发病机制和症状学资料。
ResultsTCsmaybeoverlookedforthefollowingreasons:(1)STCsareconsideredclinicallyirrelevantfindings;(2)itisassumedthatitisclinicallydifficulttoascertainthatTCsarethecauseofpain;(3)MRIorelectromyographystudiesonlyfocusontheL1toS1nerves;(4)TCsareusuallynotreportedbyradiologists;(5)degenerativealterationsofthelumbosacralspinearealmostalwaysidentifiedasthecauseofapatient’spain;(6)itisnotgenerallyknownthatsmallTCscanbesymptomatic;(7)examinationsandtreatmentsusuallyfocusonthecystsasanunderlyingmechanism;however,essentially,increasedHPisthemainunderlyingmechanismforproducingsymptoms.Consequently,STCsmayrelapseaftersurgery;(8)bladder,bowelandsphincterdysfunctionsarenotinquiredaboutduringhistorytaking.(9)Unexplainedpainisoftenattributedtodepression,whereasdepressionismorelikelytheconsequenceofdebilitatingneuropathicpain.(10)TherecognitionofSTCsissubjecttogenderbias,confirmationbiasandcognitivedissonanceandunconsciousbiasinpublishing.
由于以下原因，TCs可能被忽视：（1）骶管囊肿被认为与临床症状无关；（2）认为临床上很难确定骶管囊肿是疼痛的原因；（3）MRI或肌电图研究只