Health-Related Quality-of-Life Outcomes in Surgical Patients With Sacral Tarlov Cysts: A 2-Year Prospective Study

BACKGROUND AND OBJECTIVES: We describe our longitudinal experience with patients who underwent surgical treatment for Tarlov cysts. General and disease-specific validated outcome measures were used to assess health-related quality of life through 2 years postoperatively. METHODS: Patients who underwent surgical treatment for sacral Tarlov cysts between 2008 and 2023 were included. Demographics and cyst characteristics were documented. End points were the disease-specific Tarlov Quality-of-Life Scale and general health-related quality-of-life measures including the Oswestry Disability Index, visual analog pain Scales, and Short-Form 36. Patients completed survey measures preoperatively and at 3, 6, 12, and 24 months after surgery. RESULTS: Data were obtained from 417 patients with an average age of 52.5 ± 11.2 years, and 91.1% was female. Patients reported significant improvement in the Tarlov Cyst Quality of Life (3.2 ± 0.1 to 2.1 ± 0.1, P < .001), visual analog pain scales at rest (4.5 ± 0.1 to 2.3 ± 0.1, P < .001) and upon activity (5.7 ± 0.2 to 3.1 ± 0.1, P < .001), and the Oswestry Disability Index (45.5 ± 0.8 to 31.6 ± 1.0, P < .001). Patients also reported improvement on 7 of the 8 Short Form 36 scales: Physical Functioning, Physical Limitations, Bodily Pain, Vitality, Social Functioning, Emotional Limitations, and Mental Health ( P < .001 for all models). There was significant improvement from the 1 to 2 years for physical functioning ( P = .040) and social functioning ( P = .016). The median tolerated sitting time increased from 15 min preoperatively to 45 minutes at 2 years postoperatively. CONCLUSION: This study, to our knowledge, is the first to demonstrate significant improvement in patients surgically treated for Tarlov cysts using general and disease-specific health-related quality-of-life scales for 2 years after surgery. Our results suggest that patients may continue to improve for up to 2 years after surgery in some domains.