Clinical Presentation and Natural History
The classic symptoms of syringomyelia (i.e., suspended sensory loss, segmental weakness and burning) are often not present in individuals with SCI. Many individuals may lack symptoms in general or present with nonspecific symptoms that may be attributed to other complications of SCI such as spasticity, autonomic dysreflexia or neuropathic pain. Most commonly, symptoms include radicular pain, gait ataxia, sensory disturbance, dysesthesias or motor weakness (Brodbelt & Stoodley 2003; Klekamp & Samii 2002; Kramer & Levine 1997; Lyons et al. 1987). As syringomyelia progresses, reduction in sensation and increased spasticity may be seen (Carroll & Brackenridge 2005). Progression is usually slow in most patients, with the clinical presentation remaining static for many years (Mariani et al. 1991). According to a recent population-based study by Chen et al. (2020), the survival rate at 10-year follow-up after syringomyelia diagnosis in individuals with SCI was approximately 68.6%, which was comparable to that of individuals with SCI who did not have syringomyelia. Among individuals with syringomyelia post SCI, age ≥ 60 and <30 years, spinal cord or spinal canal operations within 1 year after syringomyelia diagnosis, history of pneumonia, and history of coronary heart disease were identified as risk factors for long-term mortality.