Radiographic assessment of surgical treatment of post-traumatic syringomyelia

J Spinal Cord Med. 2021 Nov;44(6):861-869. doi: 10.1080/10790268.2020.1743086. Epub 2020 Mar 30.

Abstract

Context: Symptomatic post-traumatic syringomyelia can affect the quality of life in patients whose neurologic function has already been impacted by a spinal cord injury.Objective: To investigate the radiographic and clinical outcomes following surgery for syringomyelia, we present a literature review along with a case series from a single surgeon's experience.Methods: A retrospective review was conducted on patients with post-traumatic syringomyelia who were treated by a single surgeon. Thirty-four patients who underwent surgical treatment consisting of syrinx fenestration, lysis of adhesions, and duraplasty were identified. In addition, a narrative literature review was conducted with a primary focus on diagnosis and management of post-traumatic syringomyelia.Results: Literature review suggests that regardless of age, sex, vertebral location, or severity of trauma, patients who experience a spinal cord injury should be closely monitored for post-traumatic syringomyelia. Retrospective review of our 34 patients revealed 24 patients for whom pre- and post- operative MRI was available. The predominant location of the injury was cervical (15). The average syrinx length, measured in spinal segments, was similar when comparing pre- and post-operative MRIs; average syrinx length was 5.5 and 5.4 spinal segments, respectively. In contrast, syrinx axial dimension was decreased in 16 of the patients post-operatively and stable or increased in the other eight. The change in syrinx size did not correlate with clinical outcomes.Conclusion: Current surgical treatment of post-traumatic syringomyelia involves restoration of normal CSF flow dynamics; further prospective work is needed to correlate the clinical state, radiographic measures, and efficacy of surgical intervention.

Keywords: Post-traumatic syringomyelia; Spinal cord injury; Syringomyelia; Syrinx; Traumatic syringomyelia.

Publication types

  • Review

MeSH terms

  • Humans
  • Magnetic Resonance Imaging
  • Quality of Life
  • Retrospective Studies
  • Spinal Cord Injuries* / complications
  • Spinal Cord Injuries* / surgery
  • Syringomyelia* / diagnostic imaging
  • Syringomyelia* / etiology
  • Syringomyelia* / surgery