Operative Neurosurgery 30:379–384, 2026
This article validates the 11-item Tarlov Cyst Quality-of-Life (TCQoL) scale for male patients undergoing surgical treatment of sacral Tarlov cysts, demonstrating good internal consistency (Cronbach α = 0.85), significant postoperative improvement on nine items, and strong concurrent validity with ODI and SF-36 physical function and pain subscales. The TCQoL showed large responsiveness (SRM = 0.81) and correlated with VAS pain measures.
Methods include prospective preoperative and 3-month postoperative administration of TCQoL, ODI, SF-36, and VAS in 46 male patients treated surgically between 2016–2023, with detailed psychometric analyses assessing discriminative validity, construct validity, and responsiveness; limitations noted include small sample size, single-surgeon single-center design, and 20% attrition.
TCQoL Validation in Men: The Tarlov Cyst Quality-of-Life (TCQoL) scale, previously validated in women, was successfully validated for male patients undergoing surgical treatment for symptomatic sacral Tarlov cysts, demonstrating good internal consistency (Cronbach α = 0.85) and discriminative validity.
Study Population: The study included 46 male patients (final sample) with an average age of 48.4 years, mostly presenting with multiple sacral cysts and a median symptom duration of nearly 35 months.
Surgical Technique: Surgery involved a posterior approach with laminectomy, cyst drainage, and wrapping of the nerve root with a bovine pericardium sleeve to prevent refilling, followed by closure with a resorbable plate.
Symptom Improvement: Significant improvement was observed in 9 of 11 TCQoL items postoperatively, especially for discomfort while sitting, sacral pain, lower extremity pain, and weakness; sexual function items showed no significant change.
Correlation with Established Measures: The TCQoL showed strong positive correlation with the Oswestry Disability Index (ODI) (r = 0.63, P < .001) and moderate to strong negative correlations with key SF-36 subscales (physical function, bodily pain, vitality, and social functioning), indicating good concurrent validity.
Scale Responsiveness: The standardized response mean (SRM) for TCQoL was 0.81, indicating a large effect size and sensitivity to clinical change after surgery.
Limitations: The study is limited by a small sample size (reflecting the rarity of Tarlov cysts in men), single-center and single-surgeon design, and a 20% attrition rate; findings may not generalize to non-sacral or non-Tarlov cysts.
Clinical Utility: The TCQoL can now be used as a disease-specific HRQoL tool for both male and female patients with symptomatic sacral Tarlov cysts, supporting standardized outcome measurement in future research and clinical practice.
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