Retrospective case study of post-traumatic syringomyelia

ABSTRACT

this is a retrospective review of patients with symptomatic post-traumatic syringomyelia. We examine initial symptoms, surgical treatment and outcome using clinical and magnetic resonance imaging [MRI] data. Surgical treatments included shunting or duraplasty, with or without lysis of adhesions. Method: twenty patients post-traumatic syringomyelia were identified, and had sufficient clinical and radiological data for inclusion in this study. All data was collected in a retrospective manner using available documentation and radiological images. Deficits in pain sensation, weakness, or pain and paraesthesias were each present in 70% of all presenting signs and symptoms. Shunting alone often required revision with subsequent operations in 56% of cases, while duraplasty required revision in only one of five patients. Lysis of adhesions appears to be most effective when performed with duraplasty. Increase in syrinx size on follow-up MRI examination correlates with clinical regression, while decrease in syrinx size correlates with clinical stability or improvement. we conclude that shunting alone is an ineffective method for treatment of symptomatic post-traumatic syringomyelia. Duraplasty provides more definitive treatment when compared to shunting alone. MRI study of syrinx at follow-up is an accurate predictor or clinical outcome: