AA

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There is level 2 evidence (from one cohort, four 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; Tassigny et al. 2017; Davidson et al. 2018) 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.

There is level 4 evidence (from one pre-post study; Vaquero et al., 2018a) that mesenchymal stromal cell therapy may be effective in improving spinal cord function post-SCI.