Brief Summary
The goal of this observational study is to evaluate the long-term outcomes of different surgical techniques for sacral Tarlov cysts in adult patients aged 18-75 years diagnosed with symptomatic sacral Tarlov cysts. The main questions it aims to answer are:
* Does one surgical technique result in better pain relief (measured by VAS score) and functional recovery (measured by JOA score) compared to others? * How do different surgical techniques impact the long-term recurrence rate and complication rate?
Researchers will compare three surgical techniques:
1. Partial cyst wall resection with nerve root sleeve plasty. 2. Partial cyst wall resection with nerve root sleeve reinforcement and reconstruction. 3. Autologous fat/muscle with fibrin glue microscopic cyst filling.
Participants will:
* Undergo one of the three surgical procedures based on clinical indications. * Complete preoperative and postoperative assessments, including pain and functional scoring, as well as MRI evaluations at baseline and during follow-up. * Participate in a follow-up program for up to 2 years to monitor outcomes and recurrence.
Age 18-75 years.
Diagnosed with symptomatic sacral Tarlov cysts confirmed by MRI.
Persistent sacral or lower back pain (VAS score ≥ 4).
Neurological deficits such as lower extremity numbness or weakness.
History of prior sacral Tarlov cyst surgery.
Concurrent spinal conditions requiring separate surgical intervention.
Active infection or systemic inflammatory disease.
Severe comorbidities that increase surgical risk (e.g., advanced cardiac or pulmonary disease).
The study population includes adult patients aged 18-75 years diagnosed with symptomatic sacral Tarlov cysts, recruited from the Department of Neurosurgery at Beijing Jishuitan Hospital. Participants must exhibit persistent symptoms such as sacral or lower back pain, neurological deficits (e.g., numbness or weakness in the lower extremities), or bowel/bladder/sexual dysfunction attributable to the cyst, confirmed by MRI. The study focuses on individuals eligible for surgical intervention without significant comorbidities or prior related surgeries. This population represents a clinically relevant cohort for evaluating the efficacy and safety of different surgical techniques for sacral Tarlov cysts.
Cohort
Prospective
Partial Cyst Wall Resection with Nerve Root Sleeve Plasty
Procedure/SurgerySurgical technique involving partial removal of the cyst wall to decompress the nerve root, followed by plasty of the nerve root sleeve to restore nerve function and prevent recurrence.
Partial Cyst Wall Resection with Nerve Root Sleeve Reinforcement and Reconstruction:
Procedure/SurgeryAdvanced surgical technique combining partial cyst wall removal with additional reinforcement and reconstruction of the nerve root sleeve to provide enhanced support and reduce the risk of cyst recurrence.
Autologous Fat/Muscle with Fibrin Glue Microscopic Cyst Filling
Procedure/SurgeryMinimally invasive surgical technique where autologous fat or muscle tissue is used to fill the cyst cavity, and fibrin glue is applied to seal the defect, aiming to obliterate the cyst and prevent cerebrospinal fluid leakage.
Pain Reduction Assessed by Visual Analog Scale (VAS)
Neurological Function Improvement Assessed by Japanese Orthopedic Association (JOA) Score
Recurrence Rate of Sacral Tarlov Cysts
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