Do I need surgery if I have an intrasacral cyst? My answer is that surgery is needed in the following cases: 1. Patients with obvious lower back pain, soreness, leg pain and other symptoms, and intermittent claudication, discharged lumbar disc herniation, spinal stenosis, etc. And after active drug and physical therapy, the symptoms did not improve. 2.It appears obvious urinary and fecal dysfunction or sexual dysfunction. 3.Progressive loss of muscle strength of lower limbs. 4.Patients with significantly enlarged cysts in the sacral canal according to the repeat MRI. 5.Patients with combined spinal cord embolism. If the above 5 conditions of intra-sacral cysts appear, surgery is required, while for the vast majority of patients without symptoms, surgery is not required. What is sacral duct cyst: Sacral duct cyst belongs to the dural cyst, which originates from the spinal cord peritoneum, so the term “intradural spinal cyst” is used to refer to this type of disease in general. There are no exact statistics on the incidence of sacral cysts in the population, but since the widespread use of MRI in clinical practice, the detection rate of sacral cysts has been increasing, causing great concern among patients. In fact, understanding the causes of sacral cysts and their treatment can greatly reduce such concerns. Sacral duct cysts are a type of spinal cyst and are broadly divided into two types: Nabors IB type Epidural spinal cysts that do not contain spinal nerve root fibers (Nabors IB type), due to congenital dural diverticulum or congenital dural defects caused by arachnoid herniation, mostly located at the level of the sacral canal S1-3, commonly found in adults, with no significant differences between men and women. Nabors type II Epidural spinal cysts containing spinal nerve root fibers, also known as Tarlov’s nerve bundle cysts or spinal nerve root diverticula (Nabors type II), are cysts formed by abnormal expansion of the distal end of the spinal nerve root sleeve, usually located at the level of S2-3 spinal ganglion or its distal end, and are usually seen in adults.