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.

Inclusion Criteria

1. Age 18-75 years.

2. Diagnosed with symptomatic sacral Tarlov cysts confirmed by MRI.

3. Presence of at least one of the following symptoms:

   • Persistent sacral or lower back pain (VAS score ≥ 4).
   • Neurological deficits such as lower extremity numbness or weakness.
   • Bowel, bladder, or sexual dysfunction attributable to the cyst.

4. Eligible for surgical intervention based on clinical evaluation.

5. Willing and able to provide written informed consent.

Exclusion Criteria

1. History of prior sacral Tarlov cyst surgery.
2. Concurrent spinal conditions requiring separate surgical intervention.
3. Active infection or systemic inflammatory disease.
4. Severe comorbidities that increase surgical risk (e.g., advanced cardiac or pulmonary disease).
5. Pregnancy or lactation.
6. Inability to comply with follow-up requirements.
7. Known allergy or contraindication to surgical materials (e.g., fibrin glue).

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.