Abstract
Syringomyelia is not a disease in its own right but a manifestation of another disease process, which incorporates either an obstruction of cerebrospinal fluid (CSF) flow in the spinal canal, tethering of the spinal cord, or an intramedullary tumor. Whenever a syrinx is demonstrated, clinical examination, analysis of the patient’s history, and neuroradiological imaging have to identify the underlying cause of the syrinx. If this cause can be identified and treated successfully, the syrinx will regress, and clinical symptoms will improve or remain stable in the future.
The significance of spinal arachnopathies for development and treatment of syringomyelia in patients without a craniospinal malformation, a spinal dysraphic malformation, or an intramedullary tumor is still not widely recognized. This chapter describes diagnostic and management algorithms for spinal arachnopathies leading to syringomyelia with a special emphasis on posttraumatic syringomyelia as well as long-term results for these patients.
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References
Aghakhani N, Baussart B, David P et al (2010) Surgical treatment of posttraumatic syringomyelia. Neurosurgery 66:1120–1127; discussion 1127
Bilston LE, Fletcher DF, Brodbelt AR et al (2003) Arterial pulsation-driven cerebrospinal fluid flow in the perivascular space: a computational model. Comput Methods Biomech Biomed Engin 6:235–241
Bilston LE, Fletcher DF, Stoodley MA (2006) Focal spinal arachnoiditis increases subarachnoid space pressure: a computational study. Clin Biomech (Bristol, Avon) 21:579–584
Brodbelt AR, Stoodley MA, Watling AM et al (2003) Fluid flow in an animal model of post-traumatic syringomyelia. Eur Spine J 12:300–306
Eneling J, Bostrom S, Rossitti S (2011) Subarachnoid hemorrhage-associated arachnoiditis and syringomyelia. Clin Neuroradiol 22:169–173
Ewelt C, Stalder S, Steiger HJ et al (2010) Impact of cordectomy as a treatment option for posttraumatic and non-posttraumatic syringomyelia with tethered cord syndrome and myelopathy. J Neurosurg Spine 13:193–199
Falci SP, Indeck C, Lammertse DP (2009) Posttraumatic spinal cord tethering and syringomyelia: surgical treatment and long-term outcome. J Neurosurg Spine 11:445–460
Fischbein NJ, Dillon WP, Cobbs C et al (1999) The “presyrinx” state: a reversible myelopathic condition that may precede syringomyelia. AJNR Am J Neuroradiol 20:7–20
Gautschi OP, Seule MA, Cadosch D et al (2011) Health-related quality of life following spinal cordectomy for syringomyelia. Acta Neurochir (Wien) 153:575–579
Goldstein B, Hammond MC, Stiens SA et al (1998) Posttraumatic syringomyelia: profound neuronal loss, yet preserved function. Arch Phys Med Rehabil 79:107–112
Greitz D (2006) Unraveling the riddle of syringomyelia. Neurosurg Rev 29:251–263; discussion 264
Hirai T, Korogi Y, Shigematsu Y et al (2000) Evaluation of syringomyelia with three-dimensional constructive interference in a steady state (CISS) sequence. J Magn Reson Imaging 11:120–126
Holly LT, Batzdorf U (2002) Slitlike syrinx cavities: a persistent central canal. J Neurosurg Spine 97:161–165
Inoue Y, Nemoto Y, Ohata K et al (2001) Syringomyelia associated with adhesive spinal arachnoiditis: MRI. Neuroradiology 43:325–330
Kasai Y, Kawakita E, Morishita K et al (2008) Cordectomy for post-traumatic syringomyelia. Acta Neurochir (Wien) 150:83–86; discussion 86
Kaynar MY, Kocer N, Gencosmanoglu BE et al (2000) Syringomyelia – as a late complication of tuberculous meningitis. Acta Neurochir (Wien) 142:935–938; discussion 938–939
Klekamp J (2002) The pathophysiology of syringomyelia – historical overview and current concept. Acta Neurochir (Wien) 144:649–664
Klekamp J (2012) Surgical treatment of Chiari I malformation – analysis of intraoperative findings, complications, and outcome for 371 foramen magnum decompressions. Neurosurgery 71:365–380; discussion 380
Klekamp J (2011) Tethered cord syndrome in adults. J Neurosurg Spine 15:258–270
Klekamp J (2013) Treatment of intramedullary tumors: analysis of surgical morbidity and long-term results. J Neurosurg Spine 19:12–26
Klekamp J (2012) Treatment of posttraumatic syringomyelia. J Neurosurg Spine 17:199–211
Klekamp J (2012) Treatment of syringomyelia related to non-traumatic arachnoid pathologies of the spinal canal. Neurosurgery 72(3):376–389
Klekamp J, Batzdorf U, Samii M et al (1997) Treatment of syringomyelia associated with arachnoid scarring caused by arachnoiditis or trauma. J Neurosurg 86:233–240
Klekamp J, Samii M (2007) Surgery of spinal tumors. Springer, Heidelberg
Klekamp J, Samii M (2001) Syringomyelia – diagnosis and treatment. Springer, Heidelberg
Klekamp J, Samii M, Tatagiba M et al (1995) Syringomyelia in association with tumours of the posterior fossa. Pathophysiological considerations, based on observations on three related cases. Acta Neurochir (Wien) 137:38–43
Klekamp J, Völkel K, Bartels CJ et al (2001) Disturbances of cerebrospinal fluid flow attributable to arachnoid scarring cause interstitial edema of the cat spinal cord. Neurosurgery 48:174–185; discussion 185–186
Kubota M, Shin M, Taniguchi M et al (2008) Syringomyelia caused by intrathecal remnants of oil-based contrast medium. J Neurosurg Spine 8:169–173
Lam S, Batzdorf U, Bergsneider M (2008) Thecal shunt placement for treatment of obstructive primary syringomyelia. J Neurosurg Spine 9:581–588
Laxton AW, Perrin RG (2006) Cordectomy for the treatment of posttraumatic syringomyelia. Report of four cases and review of the literature. J Neurosurg Spine 4:174–178
Lohle PN, Wurzer HA, Hoogland PH et al (1994) The pathogenesis of syringomyelia in spinal cord ependymoma. Clin Neurol Neurosurg 96:323–326
Milhorat TH, Capocelli AL Jr, Kotzen RM et al (1997) Intramedullary pressure in syringomyelia: clinical and pathophysiological correlates of syrinx distension. Neurosurgery 41:1102–1110
Morisako H, Takami T, Yamagata T et al (2011) Focal adhesive arachnoiditis of the spinal cord: imaging diagnosis and surgical resolution. J Craniovertebr Junction Spine 1:100–106
Nicholas DS, Weller RO (1988) The fine anatomy of the human spinal meninges. A light and scanning electron microscopy study. J Neurosurg 69:276–282
Olivier A, Tran Quan VaN (1955) A case of monstrous post-traumatic hypertrophy of the foot, of true syringomyelic type. J Radiol Electrol Arch Electr Medicale 36:808–810
Oluigbo CO, Thacker K, Flint G (2010) The role of lumboperitoneal shunts in the treatment of syringomyelia. J Neurosurg Spine 13:133–138
Parker F, Aghakhani N, Tadie M (1999) Non-traumatic arachnoiditis and syringomyelia. A series of 32 cases. Neurochirurgie 45(Suppl 1):67–83
Piatt JH Jr (2005) Progressive syringomyelia controlled by treatment of associated hydrocephalus in an infant with birth injury. Case report. J Neurosurg 103:198–202
Reddy KK, Del Bigio MR, Sutherland GR (1989) Ultrastructure of the human posttraumatic syrinx. J Neurosurg 71:239–243
Roser F, Ebner FH, Sixt C et al (2010) Defining the line between hydromyelia and syringomyelia. A differentiation is possible based on electrophysiological and magnetic resonance imaging studies. Acta Neurochir (Wien) 152:213–219; discussion 219
Sgouros S, Williams B (1996) Management and outcome of posttraumatic syringomyelia. J Neurosurg 85:197–205
Squier MV, Lehr RP (1994) Post-traumatic syringomyelia. J Neurol Neurosurg Psychiatry 57:1095–1098
Stoodley MA, Gutschmidt B, Jones NR (1999) Cerebrospinal fluid flow in an animal model of noncommunicating syringomyelia. Neurosurgery 44:1065–1075; discussion 1075–1066
Stoodley MA, Jones NR, Yang L et al (2000) Mechanisms underlying the formation and enlargement of noncommunicating syringomyelia: experimental studies. Neurosurg Focus 8:E2
Suzuki S, Chiba Y, Hidaka K et al (1998) A new operative technique of posttraumatic syringomyelia: thecoperitoneal shunt. No Shinkei Geka 26:541–546
Tobimatsu Y, Nihei R, Kimura T et al (1991) A quantitative analysis of cerebrospinal fluid flow in posttraumatic syringomyelia. Nippon Seikeigeka Gakkai Zasshi 65:505–516
Vassilouthis J, Papandreou A, Anagnostaras S (1994) Thecoperitoneal shunt for post-traumatic syringomyelia. J Neurol Neurosurg Psychiatry 57:755–756
Vengsarkar US, Panchal VG, Tripathi PD et al (1991) Percutaneous thecoperitoneal shunt for syringomyelia. Report of three cases. J Neurosurg 74:827–831
Williams B (1990) Post-traumatic syringomyelia, an update. Paraplegia 28:296–313
Williams B, Sgouros S, Nenji E (1995) Cerebrospinal fluid drainage for syringomyelia. Eur J Pediatr Surg 5(Suppl 1):27–30
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Klekamp, J. (2017). Syringomyelia. In: Weidner, N., Rupp, R., Tansey, K. (eds) Neurological Aspects of Spinal Cord Injury. Springer, Cham. https://doi.org/10.1007/978-3-319-46293-6_9
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DOI: https://doi.org/10.1007/978-3-319-46293-6_9
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