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Neurol India. 2020 Mar 19. doi: 10.4103/0028-3886.280648. [Epub ahead of print]

Surgical Treatment of Scoliosis-Associated with Syringomyelia: The Role of Syrinx Size.

Author information

1
Department of Orthopedics Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu; Department of Spine Surgery, the Affiliated Hospital of Southwest Medical University, N0.25 Taiping Road, Luzhou, Sichuan, China.
2
Department of Neurosurgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, China.
3
Department of Orthopedics Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, China.

Abstract

Background:

The treatment of the syrinx prior to correction of the scoliosis in syringomyelia-associated scoliosis (SMS) patients remains controversial. The aim of this study is to evaluate the role of the syrinx size in the management of SMS patients.

Materials and Methods:

This was a retrospective study of 36 SMS patients. They were divided into 2 groups: Group A (26 with a small syrinx, syrinx(S)/spinal cord(C) ratio ≤0.7) and Group B (10 with a large syrinx, S/C ratio >0.7). Patients with a large syrinx accepted prophylactic neurosurgery prior to scoliosis surgery. They were evaluated at baseline, 1-week and last follow-up after correction surgery for changes in curve correction, global coronal balance, thoracic kyphosis (TK), sagittal vertical axis (SVA), and Scoliosis Research Society (SRS)-22 scores.

Results:

The syrinx size of patients in Group A was significantly smaller than that of in Group B. The syrinx size was significantly decreased after prophylactic neurosurgery in Group B. The radiographic parameters of scoliosis at baseline, 1-week and last follow-up after scoliosis surgery were comparable between two groups. No abnormal signal was detected during the process of neuromonitoring in both groups. Pre- and postoperative SRS-22 scores were similar between two groups.

Conclusions:

Prophylactic neurosurgery may be beneficial for decreasing the risk of correction surgery in SMS patients with large syrinx (S/C ratio >0.7). After the intervention of syrinx prior to scoliosis correction, SMS patients with large syrinx could obtain similar clinical and radiographic outcomes of treatment with pedicle-screw-based spinal instrumentation and fusion compared to the patients with small syrinx.

KEYWORDS:

Prophylactic neurosurgery; scoliosis; syringomyelia; syrinx size

PMID:
32189709
DOI:
10.4103/0028-3886.280648
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