Radiographic assessment of surgical treatment of post-traumatic syringomyelia

Yuping D. Li, Chris Therasse, Kartik Kesavabhotla, Jason B. Lamano, Aruna Ganju*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish (US)
JournalJournal of Spinal Cord Medicine
DOIs
StateAccepted/In press - Jan 1 2020

Keywords

  • Post-traumatic syringomyelia
  • Spinal cord injury
  • Syringomyelia
  • Syrinx
  • Traumatic syringomyelia

ASJC Scopus subject areas

  • Clinical Neurology

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