The diagnosis and management of post traumatic syringomyelia

Lyons, Bernard; Brown, D J; Calvert, James; Woodward, J.; Wriedt, C. H. R.

doi:10.1038/sc.1987.62

Cited by 30 publications

(27 citation statements)

References 7 publications

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“…Sgouros and Williams 17 found that 78% of syringomyelia patients had a thoracolumbar spinal injury, whereas El Masry et al 5 and PerrouinVerbe et al 9 concluded that cavities form more commonly in thoracic compared with cervical spinal cord injury patients. In contrast, Rossier et al, 14 Lyons et al, 18 and Vannemreddy et al 6 found that syringomyelia was more commonly associated with cervical spinal cord injury. Such observations are consistent with theories suggesting that the development of syringomyelia is associated with an increase in CSF pressure, because the mid-cervical spinal canal and the subarachnoid space are both relatively narrower than the thoracolumbar canal, as shown by Yarkony et al 19 We also investigated whether syringomyelia development correlated with the severity of neurological injury.…”

Section: Discussionmentioning

confidence: 90%

Factors associated with early onset post-traumatic syringomyelia

Kim

et al. 2012

Spinal Cord

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Study design: Retrospective study. Objectives: To identify factors associated with the development of early onset post-traumatic syringomyelia within 5 years of spinal cord injury. Setting: Department of Rehabilitation Medicine, Pusan National University School of Medicine, Korea. Methods: We retrospectively examined the records of 502 patients with traumatic cervical or thoracic spinal cord injury who underwent follow-up magnetic resonance imaging (MRI) examinations more than once a year for at least 5 years. Patients were assessed in terms of the neurological level of injury, the severity of initial spinal cord injury, the use of surgery and the extent of spinal canal involvement. The latter was evaluated by calculating the shortest antero-posterior diameter of the injured vertebral canal and the spinal reserve capacity as shown on MRI at the time of trauma onset and at the time of diagnosis of syringomyelia. Results: Syringomyelia developed within 5 years in 37 (7.3%) of the 502 patients. The mean age of these 37 patients was 44.6 years (range, 17-67 years) and the mean interval from spinal cord injury to onset of syringomyelia was 38.8 months (range, 2-54 months). The development of post-traumatic syringomyelia within 5 years was not significantly related to the severity or level of injury, the use of spinal surgery or the extent of spinal canal encroachment (PZ0.05 for each comparison). Conclusion: Early onset syringomyelia occurring within 5 years after spinal cord injury was not associated with neurological injury level, severity of injury, the use of spinal surgery or canal encroachment.

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Section: Discussionmentioning

confidence: 90%

Factors associated with early onset post-traumatic syringomyelia

Kim

et al. 2012

Spinal Cord

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“…A higher incidence of PTS in quadriplegics compared with paraplegics has been reported in other series. 19,27,28 so that the matter remains unresolved. Our data suggest that lumbar spinal cord injury may be associated with later onset of PTS compared with higher injuries.…”

Section: Level Of Spinal Cord Injurymentioning

confidence: 98%

Posttraumatic syringomyelia: predisposing factors

Vannemreddy¹,

Rowed²,

Bharatwal³

2002

British Journal of Neurosurgery

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Posttraumatic spinal cord cavitation (syrinx) and progressive myelopathy associated with a posttraumatic syrinx (PTS) have been recognized for many years. Predisposing factors for PTS have not been well defined. All symptomatic PTS patients (n = 58) treated at the University of Toronto neurosurgical units over 30 years were analysed retrospectively to discover risk factors for the development of PTS. There were 46 males and 12 females (mean age 42.2 years); 28 patients had cervical (CSCI), and 30 had thoracic and lumbar spinal cord injuries (TSCI). Neurological deficit was complete in 40 (69%) compared with 43% complete injuries in the concurrent spinal and injury (SCI) population in general (p = 0.0003). Onset of PTS was earlier with: increasing age (p < 0.02), cervical and thoracic levels of injury (p < 0.007 and p < 0.02, respectively, compared with lumbar injuries), dislocated fractures (p < 0.003) and spinal surgery (p < 0.001) and, marginally, with complete SCI (p = 0.06). Mean time to onset of PTS appears to have decreased in recent years (p < 0.0001). PTS follows complete spinal cord injury (SCI) more often than incomplete and is frequently associated with arachnoiditis. Onset is earlier with increasing age, cervical and thoracic levels compared with lumbar, displaced fractures and spinal instrumentation without decompression. A group of SCI patients who are at greater risk of developing early PTS is thus identified, facilitating cost-effective follow-up.

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“…The close relationship between the syringomyelic cavity and the vertebral fracture supports the thesis that the latter is a relevant factor for the development of the cavity, as occurs in the case we present. 12,13 Post-traumatic syringomyelia appears both in patients submitted to conservative therapy (as in our patient) and in those who have undergone surgery in the acute phase of the spinal cord injury; a similar incidence has been described for both groups. No large series comparing both groups exists in the literature, and even the series with surgically-treated patients are scarce.…”

Section: Discussionmentioning

confidence: 67%

“…At present, the preferred procedure is to establish a shunt between the syringomyelic cavity and a low pressure Post-traumatic syringomyeliasystem implanted at thoracic or abdominal level, resulting in a much lower incidence of obstruction in comparison to previous types of shunt. 13,17,18 In general, the results with surgery are favourable. All series agree as to the relief of pain in almost all cases, followed by improvement of the motor de®cit; the least observed improvement is the recovery of sensitivity, although the series presented by Lyons 13 and El Masry 3 describe a postoperative recovery of sensitivity of 91% and 73%, respectively.…”

Section: Discussionmentioning

confidence: 93%

“…13,17,18 In general, the results with surgery are favourable. All series agree as to the relief of pain in almost all cases, followed by improvement of the motor de®cit; the least observed improvement is the recovery of sensitivity, although the series presented by Lyons 13 and El Masry 3 describe a postoperative recovery of sensitivity of 91% and 73%, respectively. In the case of our patient, both operations were followed by worsening of the neurological level.…”

Section: Discussionmentioning

confidence: 93%

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Post-traumatic syringomyelia following complete neurological recovery

2000

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Objective: To describe the later neurologic deterioration secondary to the appearance of a post-traumatic syringomyelic cavity, in a patient who, in the initial phase, had an incomplete spinal cord lesion (ASIA C), which improved to ASIA E. Methods: A 52-year-old male patient who, at the age of 19 (1965), suered a spinal cord injury. He presented with a fracture of the sixth and seventh cervical neurological segment at the time of the lesion, evolving to ASIA E. Nine years after the traumatism, he began to feel pain accompanied by a sensory and motor de®cit. Results: With the aid of myelography and MRI, the existence of a syringomyelic cavity was detected, which extended from the fourth to the seventh cervical segments. The patient was operated on, on various occasions, placing a syringo-subarachnoid shunt. The neurological status of the patient continued to deteriorate and, at present, he has a complete lesion below the fourth neurological cervical segment with a partially preserved sensitive area up to T1. Conclusion: The development of the syringomyelic cavity could be one of the causes of later neurologic deterioration in patients with traumatic spinal cord injury with neurological recovery`ad integrum' in the initial phase of spinal cord injury.

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The diagnosis and management of post traumatic syringomyelia

Cited by 30 publications

References 7 publications

Factors associated with early onset post-traumatic syringomyelia

Factors associated with early onset post-traumatic syringomyelia

Posttraumatic syringomyelia: predisposing factors

Post-traumatic syringomyelia following complete neurological recovery

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