Someone else will give you a better answer later I'm sure, since I am also pretty new to Sil. But my understanding is that Sil-Q isn't a huge rewrite of the original Sil, rather, it is a continuation of the effort to improve and tighten the design. Things that weren't working have been removed or reworked, and interesting additions have been made. I went straight to Sil-Q myself.
If you want a very detailed list of changes you can read the Sil-Q manual, which is focused on outlining how Sil-Q changes the original game.
I think its worth doing the whole song of slaying in the centre of the throne room thing, classic Sil has at least once. Whether you do that after winning Sil-q is up to you. I mostly prefer Sil-q though I think the early stealth game was harder in the original so thats nice to do for a challenge.
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