Clinical characteristics and treatment strategy for intrasacral cysts complicated by tethered cord syndrome

Purpose This study aimed to investigate the clinical features, surgical treatment, and outcomes of patients with intrasacral cysts complicated by tethered cord syndrome (TCS). Methods In this retrospective single-center study, clinical data from 41 patients with intrasacral cysts complicated by TCS diagnosed by magnetic resonance imaging were analyzed. All patients underwent surgical treatment, and the curative effects were evaluated based on clinical symptoms, the Karachi score for neurological function, and the numerical rating scale (NRS) for pain. Postoperative follow-up was conducted to assess symptom improvement and overall patient outcomes. Results Study participants were followed up for 36.5 ± 22.9 months (range, 12–80). No serious postoperative complications were reported. Neurological dysfunction and related symptoms improved to varying degrees after treatment. The median Karachi scores showed a significant improvement from 13.5 (11–15) preoperatively to 15 (13–15) points at the last follow-up (Z = -4.520, P < 0.001). Similarly, the NRS scores decreased significantly from 5 (0–7) preoperatively to 2 (0–3) postoperatively (Z = -4.183, P < 0.001). Conclusions Patients with intrasacral cysts associated with TCS present a unique type of intraspinal cyst. A good prognosis can be achieved by treating both lesions simultaneously.