Table 19. Syringomyelia and Tethered Spinal Cord

Author Year

Country
Research Design
PEDro Score
Sample Size

Methods Outcomes

Falci et al. (2009b)

USA

Case Series

N=362

Population: Mean age: 40.5 yr; Level of injury: C1-C6=163, C6-T1=83, T1-S5=116; Severity of injury: AIS A=232, AIS B=36, AIS C=41, AIS D=51, AIS E=2; Mean time since injury: 10.7 yr.

Intervention: Participants who received cord untethering, expansion duraplasty, and cyst shunting for progressive myelopathy were retrospectively analyzed. Outcomes were assessed at pre-op, post-op, and follow-up.

Outcome Measures: American Spinal Injury Association (ASIA) scores; Clinical status; Complications.

1.     At post-op, participants showed significant increases in ASIA light touch score (n=308; +1.39, p=0.029) and pinprick score (n=307; +1.41, p=0.029), and a non-significant decrease in ASIA motor score (n=263; -0.32, p=0.059).

2.     At 1 yr follow-up, participants showed non-significant changes in ASIA motor score (n=100; -.128, p=0.102), light touch score (n=110; +0.74, n=0.437), and pinprick score (n=109; +0.58, p=0.633).

3.     At last follow-up, participants showed a significant decrease in ASIA motor score (n=134; -1.16, p=0.015) and non-significant changes in light touch score (n=157; -0.76, p=0.391) and pinprick score (n=157; +0.1, p=0.996).

4.     Participants reported decreases in neuropathic pain (n=99; 47%), spasticity (n=53; 60%), and hyperhidrosis (n=38; 77%).

5.     Participants reported arrest of progressive loss of both motor and sensory function (n=204; 89%), of motor function (n=152; 93%), and of sensory function (n=128; n=97%).

6.     Complications were CSF leak/collection (3.8%), DVT/PE (2.35%), wound infection (0.48%), bacterial meningitis (0.48%), myocardial infarction (0.24%), and death (0.48%).

Falci et al.

(1999) USA

Case Series

N=59

Population: Mean age: 38 yr; Gender: males=49, females=10; Level of injury: C1-C6=24, C6-T1=20, T1-S5=15; Severity of injury: AIS A=53, AIS B=1, AIS C=3, AIS D=2; Mean time since injury: 12 yr.

Intervention: Participants who received cord untethering and/or cyst shunting for progressive myelopathy were retrospectively analyzed at 1 yr post-op.

Outcome Measures: American Spinal Injury Association (ASIA) scores; Clinical status; Complications.

1.     Participants showed non-significant increases in ASIA scores when compared to pre-op (p>0.05): light touch (+0.67), pinprick (+1.3), and motor (+0.41).

2.     Participants without previous surgery (n=34) showed increases in ASIA scores when compared to pre-op: pinprick (+3.88, p<0.05), light touch (+2.38, p>.05), and motor (+1.47, p>0.05).

3.     Participants with previous surgery (n=25) showed non-significant decreases in ASIA scores when compared to pre-op (p>0.05): light touch (-0.7), pinprick (-0.8), and motor (-0.5).

4.     Participants showed recovery of lost functional activity (64.3%), substantial improvement in spasticity (62.5%), substantial improvement in neurogenic pain (55.6%), prevention of further neurologic deterioration (95.8%), and improvement in hyperhidrosis (100%).

5.     Complications were CSF leak/collection (8.4%), wound infection (1.7%), cyst recurrence (1.7%), and meningitis (1.7%).

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