Tarlov cyst syndrome is a rare, often asymptomatic disorder, characterised by 
isolated or multiple nerve-root cysts, usually occurring in the sacral spine, 
near the dorsal root ganglion, between the perineurium and endoneurium. The 
cysts may cause lower back pain, sacral radiculopathy, dyspareunia and urinary 
incontinence. There is little data in the literature on the relationship between 
Tarlov cysts and symptoms. Here, we report further details on the clinical 
impact of Tarlov cysts and investigate their pathogenesis and role as a cause of 
lumbosacral symptoms. We examined 157 patients with MRI evidence of symptomatic 
Tarlov cysts. Patients underwent complete neurological examination and were 
scored by the Hamilton Depression Rating Scale and the Visual Analogue Scale. 
Complete lower limb electromyography was performed in 32 patients. Clinical 
picture was correlated with size and number of cysts detected by MRI. Family 
history was recorded for signs of genetic inheritance. Almost all patients 
suffered perineal or lower back pain; 34 complained of sphincter and 46 of 
sexual disorders. Hamilton scores were abnormal, and family history was positive 
in a few cases. The scanty literature on Tarlov cysts mainly regards therapy by 
a neurosurgical approach. Our results provide new data on clinical impact and 
possible pathogenetic mechanisms.