Pattern of Syringomyelia in Presumed Idiopathic and Congenital Scoliosis

Abstract

Study Design: Retrospective study.Purpose: This study was undertaken to compare the patterns of syringomyelia in patients with presumed idiopathic and congenital scoliosis.Overview of Literature: The incidence of neuraxial anomalies presenting as idiopathic scoliosis ranges from 2% to 14%; the common ones are idiopathic syringomyelia (IS) and Chiari malformation type 1 (CM1) with syringomyelia. Some authors have speculated that scoliosis is caused by the asymmetrical compression of anterior horn cells by a syrinx, which causes an imbalance of the trunk musculature. In congenital scoliosis, syringomyelia is the second commonest cord anomaly, and the deformity progression depends upon the underlying vertebral abnormality, the location of the abnormality, and the age of patient, and is independent of the intraspinal anomaly.Methods: We analyzed the radiological records of 44 consecutive patients with scoliosis and syringomyelia. Of these 44 patients, 13 had IS, 12 had CM1, and 19 had congenital scoliosis. The radiographs were evaluated to determine the curve magnitude, sagittal alignment, side of convexity, and type of vertebral anomaly, if any. T1- and T2-weighted magnetic resonance imaging of the whole spine was analyzed to determine the presence of craniovertebral anomalies, syrinx length, syrinx diameter, and syrinx-cord ratio (SCR).Results: The frequency of left convex curves was 26.1%, with no significant differences across the three groups. The mean length of the syrinx was 7.2±4.9 vertebral levels, and the mean SCR was 0.39±0.2. The mean syrinx length was significantly higher in patients with CM1 and IS, compared to patients with congenital scoliosis. The mean SCR was highest in patients with CM1. In congenital scoliosis, syringomyelia was seen most frequently in patients with a failure of formation, and 63.2% had concomitant cord anomalies.Conclusions: Syrinxes were smaller in size and length in patients with congenital scoliosis, and are distinct from those seen in IS and CM1.

The Efficacy of Single-Stage Correction by Posterior Approach for Neglected Congenital Scoliosis: Comparative Analysis According to the Age of Surgical Intervention

“…The age of intervention is one of the most crucial factors in the management of congenital scoliosis [14,15]. This is due to the fact that it is better to stabilize a curve when it is small, and prevent it from worsening, than to correct the deformity when the child is grown up, when the curve becomes larger and stiffer [1,12].…”

Type I Arnold Chiari Malformation with Syringomyelia and Scoliosis: Radiological Correlations between Tonsillar Descent, Syrinx Morphology and Curve Characteristics: A Retrospective Study

“…Both these pathologies (CM and SM) have been independently recognized as risk factors for scoliosis [3,4]. While scoliosis has been reported in 25% to 85% of patients with Chiari Malformation type I (CM-I) and SM; the incidence of CM-I and SM in scoliosis patients ranges between 4% and 58% [3][4][5].…”

Diagnosis and treatment of congenital scoliosis

“…척추 내 신경 계통 기형이 18-71%까지 있다고 알려져 있 어 급격한 진행, 수술 전 확인, 신경학적 이상 증상이 있는 경 우 자기공명영상 검사가 필요하다 [6]. 흔하게 발견되는 것은 척수 공동증(syrinx), 아르놀트-히아리기형(Arnold-Chiari malformation), 두꺼워진 종사(thickened filum terminale), 척수견인증후군(tethered cord syndrome), 척수이분증 등이 다 [7]. 최근 226명의 선천성 측만증을 연구하여 43%의 신경 계 이상 발생이 보고된 바 있으며, 흉추부 기형 및 늑골 변형 이 있을 때 발생가능성이 더 높다고 하였다 [8,9].…”