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Syringomyelia

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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

  1. Aghakhani N, Baussart B, David P et al (2010) Surgical treatment of posttraumatic syringomyelia. Neurosurgery 66:1120–1127; discussion 1127

    Article  PubMed  Google Scholar 

  2. 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

    Article  PubMed  Google Scholar 

  3. Bilston LE, Fletcher DF, Stoodley MA (2006) Focal spinal arachnoiditis increases subarachnoid space pressure: a computational study. Clin Biomech (Bristol, Avon) 21:579–584

    Article  CAS  Google Scholar 

  4. 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

    PubMed  Google Scholar 

  5. Eneling J, Bostrom S, Rossitti S (2011) Subarachnoid hemorrhage-associated arachnoiditis and syringomyelia. Clin Neuroradiol 22:169–173

    Article  PubMed  Google Scholar 

  6. 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

    Article  PubMed  Google Scholar 

  7. 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

    Article  PubMed  Google Scholar 

  8. 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

    CAS  PubMed  Google Scholar 

  9. 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

    Article  Google Scholar 

  10. Goldstein B, Hammond MC, Stiens SA et al (1998) Posttraumatic syringomyelia: profound neuronal loss, yet preserved function. Arch Phys Med Rehabil 79:107–112

    Article  CAS  PubMed  Google Scholar 

  11. Greitz D (2006) Unraveling the riddle of syringomyelia. Neurosurg Rev 29:251–263; discussion 264

    Article  PubMed  Google Scholar 

  12. 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

    Article  CAS  PubMed  Google Scholar 

  13. Holly LT, Batzdorf U (2002) Slitlike syrinx cavities: a persistent central canal. J Neurosurg Spine 97:161–165

    Article  Google Scholar 

  14. Inoue Y, Nemoto Y, Ohata K et al (2001) Syringomyelia associated with adhesive spinal arachnoiditis: MRI. Neuroradiology 43:325–330

    Article  CAS  PubMed  Google Scholar 

  15. Kasai Y, Kawakita E, Morishita K et al (2008) Cordectomy for post-traumatic syringomyelia. Acta Neurochir (Wien) 150:83–86; discussion 86

    Article  CAS  Google Scholar 

  16. 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

    Article  CAS  Google Scholar 

  17. Klekamp J (2002) The pathophysiology of syringomyelia – historical overview and current concept. Acta Neurochir (Wien) 144:649–664

    Article  CAS  Google Scholar 

  18. 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

    Article  PubMed  Google Scholar 

  19. Klekamp J (2011) Tethered cord syndrome in adults. J Neurosurg Spine 15:258–270

    Article  PubMed  Google Scholar 

  20. Klekamp J (2013) Treatment of intramedullary tumors: analysis of surgical morbidity and long-term results. J Neurosurg Spine 19:12–26

    Article  PubMed  Google Scholar 

  21. Klekamp J (2012) Treatment of posttraumatic syringomyelia. J Neurosurg Spine 17:199–211

    Article  PubMed  Google Scholar 

  22. Klekamp J (2012) Treatment of syringomyelia related to non-traumatic arachnoid pathologies of the spinal canal. Neurosurgery 72(3):376–389

    Article  Google Scholar 

  23. 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

    Article  CAS  PubMed  Google Scholar 

  24. Klekamp J, Samii M (2007) Surgery of spinal tumors. Springer, Heidelberg

    Google Scholar 

  25. Klekamp J, Samii M (2001) Syringomyelia – diagnosis and treatment. Springer, Heidelberg

    Google Scholar 

  26. 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

    Article  CAS  Google Scholar 

  27. 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

    CAS  PubMed  Google Scholar 

  28. 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

    Article  PubMed  Google Scholar 

  29. Lam S, Batzdorf U, Bergsneider M (2008) Thecal shunt placement for treatment of obstructive primary syringomyelia. J Neurosurg Spine 9:581–588

    Article  PubMed  Google Scholar 

  30. 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

    Article  PubMed  Google Scholar 

  31. Lohle PN, Wurzer HA, Hoogland PH et al (1994) The pathogenesis of syringomyelia in spinal cord ependymoma. Clin Neurol Neurosurg 96:323–326

    Article  CAS  PubMed  Google Scholar 

  32. 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

    Article  CAS  PubMed  Google Scholar 

  33. 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

    Google Scholar 

  34. 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

    Article  CAS  PubMed  Google Scholar 

  35. 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

    CAS  PubMed  Google Scholar 

  36. Oluigbo CO, Thacker K, Flint G (2010) The role of lumboperitoneal shunts in the treatment of syringomyelia. J Neurosurg Spine 13:133–138

    Article  PubMed  Google Scholar 

  37. Parker F, Aghakhani N, Tadie M (1999) Non-traumatic arachnoiditis and syringomyelia. A series of 32 cases. Neurochirurgie 45(Suppl 1):67–83

    PubMed  Google Scholar 

  38. 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

    PubMed  Google Scholar 

  39. Reddy KK, Del Bigio MR, Sutherland GR (1989) Ultrastructure of the human posttraumatic syrinx. J Neurosurg 71:239–243

    Article  CAS  PubMed  Google Scholar 

  40. 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

    Article  Google Scholar 

  41. Sgouros S, Williams B (1996) Management and outcome of posttraumatic syringomyelia. J Neurosurg 85:197–205

    Article  CAS  PubMed  Google Scholar 

  42. Squier MV, Lehr RP (1994) Post-traumatic syringomyelia. J Neurol Neurosurg Psychiatry 57:1095–1098

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Stoodley MA, Gutschmidt B, Jones NR (1999) Cerebrospinal fluid flow in an animal model of noncommunicating syringomyelia. Neurosurgery 44:1065–1075; discussion 1075–1066

    Article  CAS  PubMed  Google Scholar 

  44. Stoodley MA, Jones NR, Yang L et al (2000) Mechanisms underlying the formation and enlargement of noncommunicating syringomyelia: experimental studies. Neurosurg Focus 8:E2

    Article  CAS  PubMed  Google Scholar 

  45. Suzuki S, Chiba Y, Hidaka K et al (1998) A new operative technique of posttraumatic syringomyelia: thecoperitoneal shunt. No Shinkei Geka 26:541–546

    CAS  PubMed  Google Scholar 

  46. 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

    CAS  PubMed  Google Scholar 

  47. Vassilouthis J, Papandreou A, Anagnostaras S (1994) Thecoperitoneal shunt for post-traumatic syringomyelia. J Neurol Neurosurg Psychiatry 57:755–756

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Vengsarkar US, Panchal VG, Tripathi PD et al (1991) Percutaneous thecoperitoneal shunt for syringomyelia. Report of three cases. J Neurosurg 74:827–831

    Article  CAS  PubMed  Google Scholar 

  49. Williams B (1990) Post-traumatic syringomyelia, an update. Paraplegia 28:296–313

    Article  CAS  PubMed  Google Scholar 

  50. Williams B, Sgouros S, Nenji E (1995) Cerebrospinal fluid drainage for syringomyelia. Eur J Pediatr Surg 5(Suppl 1):27–30

    Article  PubMed  Google Scholar 

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Correspondence to Jörg Klekamp .

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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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