Prospective Validation of a Quality-of-Life Measure for Women Undergoing Surgical Intervention for Symptomatic Sacral Tarlov Cysts: The Tarlov Cyst Quality of Life Scale

Abstract

Background: The use of health-related quality-of-life scales has expanded into most areas of medicine. Established quality-of-life scales are used in several areas of neurosurgery, but none have been validated for use in patients with symptomatic Tarlov cysts. The majority of symptomatic Tarlov cysts are found in the sacral spinal canal of women. We, therefore, validated a site-specific quality-of-life measure for women with symptomatic sacral nerve root compression caused by Tarlov cysts.

Methods: Women undergoing surgical treatment for sacral Tarlov cysts at a single institution between 2017 and 2020 were enrolled in this prospective validation study. Participants were administered a 13-item version of the survey along with other validated quality-of-life measures preoperatively and at 3 months postoperatively. Psychometric analyses were performed to validate the measure.

Results: One hundred twelve patients met inclusion criteria and completed surveys preoperatively and at 3 months postoperatively. Patients' mean scale scores decreased significantly preoperatively to postoperatively, reflecting good discriminability (P < 0.001). Interitem correlations suggested 2 items were correlated at >0.80, which were dropped to create an 11-item scale. The internal consistency of the 11-item scale was 0.822. Concurrent validity was established by correlating scale scores with the Oswestry Disability Index (P < 0.001) and the physical function (P < 0.001) and pain (P < 0.001) subscales of the Short-Form 36 Survey.

Conclusions: We prospectively validated a site-specific, health-related quality-of-life survey for women with symptomatic sacral Tarlov cysts. This measure will be useful in future studies to inform clinicians and researchers about the progression of Tarlov cysts and patient response to surgical treatment.

Keywords: Health-related quality of life; Perineural cyst; Psychometric; Sacrum; Tarlov cyst.