Long-Term Outcomes of Different Surgical Techniques for Sacral Tarlov Cysts: a Prospective Cohort Study

Beijing Jishuitan Hospital

Status: Not yet enrolling

Conditions: Neurological Dysfunction Associated with Tarlov Cysts; Sacral Tarlov Cysts; Symptomatic Sacral Cysts; Chronic Pain Related to Sacral Cysts

Treatments: Procedure: Autologous Fat/Muscle with Fibrin Glue Microscopic Cyst Filling; Procedure: Partial Cyst Wall Resection with Nerve Root Sleeve Reinforcement and Reconstruction:; Procedure: Partial Cyst Wall Resection with Nerve Root Sleeve Plasty

Study type: Observational

Funder types: Other

Identifiers

NCT06756984

STC_2025

Details and patient eligibility

About

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.

Enrollment: 150 estimated patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

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).

Trial design

150 participants in 3 patient groups

Partial Cyst Wall Resection with Nerve Root Sleeve Plasty

Description:

Participants in this group will undergo partial resection of the cyst wall combined with nerve root sleeve plasty. This technique involves reducing the cyst size and reconstructing the nerve root sleeve to restore nerve function and reduce symptoms.

Treatment:

Procedure: Partial Cyst Wall Resection with Nerve Root Sleeve Plasty

Partial Cyst Wall Resection with Nerve Root Sleeve Reinforcement and Reconstruction

Description:

Participants in this group will undergo partial resection of the cyst wall along with reinforcement and reconstruction of the nerve root sleeve. This method provides additional structural stability to the nerve root and aims to reduce the risk of recurrence and improve postoperative outcomes.

Treatment:

Procedure: Partial Cyst Wall Resection with Nerve Root Sleeve Reinforcement and Reconstruction:

Autologous Fat/Muscle with Fibrin Glue Microscopic Cyst Filling

Description:

Participants in this group will receive autologous fat or muscle tissue filling of the cyst cavity combined with fibrin glue sealing under microscopic guidance. This technique aims to obliterate the cyst cavity, prevent cerebrospinal fluid leakage, and enhance symptom relief and recovery.

Treatment:

Procedure: Autologous Fat/Muscle with Fibrin Glue Microscopic Cyst Filling