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Syringomyelia is a term used to describe the formation of an intramedullary cyst filled with cerebrospinal fluid within the spinal cord. The pathophysiology of syringomyelia following SCI is not completely understood. Magnetic resonance imaging is currently the diagnostic test of choice for diagnosing syringomyelia and is able to detect fluid movement, syringomyelia and other abnormalities.

There is level 2 evidence (from one cohort, one pre-post, and five case series studies; Karam et al. 2014; Ushewokenze et al. 2010; Schaan & Jaksche 2001; Falci et al. 1999; Lee et al. 2000; Lee et al. 2001; Hess & Foo 2001; Hida et al. 1994) that shunting improves pain, motor function and sensory loss in some SCI patients with syringomyelia; however, a high rate of shunt failure has been observed; these findings are tempered by level 4 evidence (from one pre-post study; Karam et al. 2014) that reported minimal clinical improvement post shunting with or without duraplasty.

There is level 4 evidence (from one pre-post and three case series studies; Falci et al. 2009; Falci et al. 1999; Lee et al. 2000; Lee et al. 2001) that untethering improves motor and sensory loss.

There is level 4 evidence (from two case series studies; Lee et al. 2000; Lee et al. 2001) that untethering improves spasticity in more patients with syringomyelia than shunting.

There is level 4 evidence (from one pre-post study; Hayashi et al. 2013) that subarachnoid-subarachnoid bypass may improve motor and bladder functioning post SCI-related syringomyelia.

There is level 4 evidence (from one pre-post study; Ewelt et al. 2010) that cordectomy improves motor and sensory function post SCI-related syringomyelia.

There is level 4 evidence (from one pre-post study; Gautschi et al. 2011) that cordectomy improves quality of life of individuals post SCI-related syringomyelia.

There is level 5 evidence (from two case reports; Falci et al. 1997; Wirth III et al. 2001) that embryonic tissue transplantation along with drainage, untethering and shunting may obliterate syringomyelia cysts and improve sensory loss.