Treatment Possibilities
for arachnoiditis and Tarlov cysts

Information in the internet cannot ever replace a confidential conversation with the treating physician.

The information here cannot cover the entire range of therapeutic possibilities of Arachnoiditis and Tarlov-cysts.

Within the medical community there is no clear and highly evident therapy guideline. The concept covered here is based on many years of treatment experience with this disease.

The basics for the treatment of Leptomeninges.


  • If a diagnosis is certain or if it very probable that an aseptic Arachnoiditis is present, a therapy should be considered.
  • This therapy includes the entire symptomatic therapy of pain management, immune system strengthening up to immunomodulation.
  • Food guidelines, which can individually vary from vegan to non-carbohydrate and protein rich. There is no single guideline for all patients.
  • Healthy lifestyle, moving as much as possible and high doses of Vitamins (in particular Vitamin C) are highly recommended.
  • With increasing neurological failure symptoms, surgical and endoscopic treatment procedures are called for. During these treatments the inter-adhesion of the nerve roots within the dural sac, as well as their emergence from the dural sac is to be untangled. These treatments are by now following clear rules, indications and counterindications according to the experience of the authors.
  • The key to a successful therapy is a clear diagnosis. When neurological symptoms leave no other explanations, a therapy should be undertaken.

Tarlov cysts

  • Cysts without corresponding complaints are considered asymptomatic and do not require therapy.
  • Cysts with symptoms require therapy. For the treatment of symptoms, in addition to the removal of the cysts and their narrowing effect on other nerve structures, the original disruption of the cerebrospinal fluid circulation is the primary focus of the interventional treatment. There are various treatment options in the pursuit of the surgical goals.
  • A common goal should be that the cysts are removed permanently so they do not return and that the cause of their emergence is permanently eliminated.
  • The surgical procedures include several surgical techniques which can include cerebrospinal fluid derivation surgery using valve systems or a combination of endoscopic and micro-surgical operations with the capping of cyst fistula, filling of cavities in the sacrum using fatty tissue transplantation and bone reconstruction of the sacrum.

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