Update on the pathophysiology and management of syringomyelia unrelated to Chiari malformation

Giner, Javier Micó; López, Carlos Pérez; Hernández, B.; Riva, Á. Gómez de la; Isla, Alberto; Roda, J.M.

doi:10.1016/j.nrleng.2018.10.004

Cited by 18 publications

(21 citation statements)

References 31 publications

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“…The pathophysiology of syringomyelia is uncertain. However, several hypothetical theories have been postulated to explain the development of syringomyelia [ 3 , 11 ]. Syringomyelia has been associated with non-infectious inflammatory lesions [ 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…The clinical course progresses over months to years with an early rapid deterioration that wanes over time [ 13 ]. Although there are no specific symptoms associated with syringomyelia, sensory abnormalities, motor weakness, and pain are the most common manifestations [ 3 ]. Our patient similarly presented with these manifestations and had no previous history of trauma or an infectious illness.…”

Section: Discussionmentioning

confidence: 99%

“…It is most frequently associated with Chiari 1 malformation, which accounts for half of the cases. Other causes include trauma, spinal cord tumors, post-inflammatory cord lesions, and secondary myelomalacia [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

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Coexistence of Systemic Lupus Erythematosus and Syringomyelia: A Case From a Rural Center in Nigeria

Emorinken¹,

Erameh²,

Eluehike³

et al. 2021

Cureus

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Systemic lupus erythematosus and syringomyelia are two distinct conditions with different pathogenetic pathways as well as diverse genetic and clinical characteristics. The coexistence of these two conditions has not been previously documented in the literature. We describe a 38-year-old male who presented with progressive bilateral weakness and pain in the lower limbs and loss of sphincteric functions three years following a diagnosis of lupus nephritis. Relevant autoantibody testing, hypocomplementemia, and biopsyproven membranous lupus nephritis confirmed the diagnosis of systemic lupus erythematosus and magnetic resonance imaging of the spine confirmed the presence of syringomyelia. Therapy for lupus nephritis was instituted accordingly, while the patient was referred for neurosurgical intervention. The mechanism underlying syrinx formation in this patient is uncertain and, thus, further research is critical in this area.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Coexistence of Systemic Lupus Erythematosus and Syringomyelia: A Case From a Rural Center in Nigeria

Emorinken¹,

Erameh²,

Eluehike³

et al. 2021

Cureus

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“…Surgical fixation as a primary treatment was purely based on the surgeon's choice and based on the recent publications. 12,[23][24][25] In 9 of these patients, a bony decompression (removal of the posterior rim of FM) was also added.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Type I Chiari Malformation Without Concomitant Bony Instability: Assessment of Different Surgical Procedures and Outcomes in 73 Patients

et al. 2021

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Posterior fossa decompression is the treatment of choice in type 1 Chiari malformation (CM-1) without bony instability. Although surgical fixation has been recommended by a few authors recently, comparative studies to evaluate these treatment strategies using objective outcome tools are lacking. Methods: Seventy-three patients with pure CM-1 (posterior fossa bony decompression [PFBD], n = 21; posterior fossa bony and dural decompression [PFBDD], n = 40; and posterior fixation [PF], n = 12) underwent a postoperative outcome assessment using Chicago Chiari Outcome Score (CCOS). Logistic regression analysis detected predictors of an unfavorable outcome. Results: Minimally symptomatic patients generally underwent a PFBD while most of the clinically severe patients underwent a PFBDD (p = 0.049). The mean CCOS score at discharge was highest in the PF (12.0 ± 1.41) and lowest in PFBDD group (10.98 ± 1.73, p = 0.087). Patients with minimal preoperative clinical disease severity (adjusted odds ratio [AOR], 4.58; 95% confidence interval [CI], 1.29-16.31) and PFBDD (AOR, 7.56; 95% CI, 1.70-33.68) represented risks for an unfavorable short-term postoperative outcome. Though long-term outcomes (CCOS) did not differ among the 3 groups (p = 0.615), PFBD group showed the best long-term improvements (mean follow-up CCOS, 13.71 ± 0.95), PFBDD group improved to a comparable degree despite a poorer short-term outcome while PF had the lowest scores. Late deteriorations (n = 3, 4.1%) occurred in the PFBDD group. Conclusion:Minimally symptomatic patients and PFBDD predict a poor short-term postoperative outcome. PFBD appears to be a durable procedure while PFBDD group is marred by complications and late deteriorations. PF does not provide any better results than posterior fossa decompression alone in the long run.

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“…One of the mechanisms in chronic SCI was the development of gliotic scar and cerebrospinal fluid (CSF) accumulation inside the spinal cord caused "fluidfilled cavities," also called syringomyelia (Figure 1) [11]. Traumatic syringomyelia develops for about 4.5% of patients with SCI [12].…”

Section: Sci and Pathophysiologymentioning

confidence: 99%

Mesenteric Neural Stem Cell for Chronic Spinal Cord Injury: A Literature Review

Mahadewa

Mardhika

Awyono

et al. 2021

Open Access Maced J Med Sci

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Spinal cord injury (SCI) is a common and potentially life-threatening condition with no established treatment to treat the primary injury. Mesenteric neural stem cell (NSC) therapy is a promising stem cell therapy to treat primary SCI in the chronic phase. We aimed to review the literature narratively to describe current evidence regarding mesenteric NSC in SCI. Primary SCI refers to tissue damage that occurs at the time of trauma that leads to the death of neuronal cells. In chronic SCI, the ability of neuronal regeneration is compromised by the development of gliotic scar. NSC is a stem cell therapy that targeted SCI in the chronic phase. Enteric NSC is one of the sources of NSC, and autologous gut harvesting in the appendix using endoscopic surgery provides a more straightforward and low-risk procedure. Intramedullary transplantation of stem cell with ultrasound guiding is administration technique which offers long-term regeneration. Mesenteric NSC is a promising stem cell therapy to treat chronic SCI with low risk and easier procedure to isolate cells compared to other NSC sources.

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Update on the pathophysiology and management of syringomyelia unrelated to Chiari malformation

Cited by 18 publications

References 31 publications

Coexistence of Systemic Lupus Erythematosus and Syringomyelia: A Case From a Rural Center in Nigeria

Coexistence of Systemic Lupus Erythematosus and Syringomyelia: A Case From a Rural Center in Nigeria

Type I Chiari Malformation Without Concomitant Bony Instability: Assessment of Different Surgical Procedures and Outcomes in 73 Patients

Mesenteric Neural Stem Cell for Chronic Spinal Cord Injury: A Literature Review

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