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Observation between Clinical Outcomes and the Size of the Syrinx with Magnetic Resonance Image  

Hwang, Ju-Yeon (Department of Neurosurgery, National Medical Center)
Kim, Young-Jin (Department of Neurosurgery, Hanyang University Medical Center)
Oh, Seong-Hoon (Department of Neurosurgery, Hanyang University Medical Center)
Kang, Jae-Kyu (Department of Neurosurgery, National Medical Center)
Kim, Young-Soo (Department of Neurosurgery, Hanyang University Medical Center)
Publication Information
Journal of Korean Neurosurgical Society / v.40, no.3, 2006 , pp. 169-174 More about this Journal
Abstract
Objective : This study was conducted to examine the correlation between clinical outcomes and the size of the syrinx in post-operative magnetic resonance imaging[MRI] and symptom duration. Methods : The authors investigated twelve patients who underwent various operations for syringomyelia from January 1995 to December 2003. The authors retrospectively analyzed medical records. pre- and post-operative MRI findings, features and durations of symptoms, and the method of surgical treatments. The clinical outcomes were assessed on Prolo scale at 6 months of post-operative period. Results : Neurologic symptoms did not promptly disappear after the shrinkage of syrinx, but post-operative MRI demonstrated most patients showed reductions in the size of the syrinx. There is no statistical relationship between clinical improvements and decrements of the syrinx size. However, patients who underwent surgical treatment within 2 years from the symptom onset had more favorable outcome than those who had operations after 2 years from the onset of symptoms. Conclusion : Change in the size of the syrinx in post-operative MRI is not directly proportional to favorable clinical outcomes. However, symptom duration before surgical treatment has considerable impact on the clinical outcomes.
Keywords
Syringomyelia; Syringosubarachnoid shunt; Posterior fossa decompression; Chiari malformation;
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1 Axel L, Dougherty L : MR imaging of motion with spatial modulation of magnetization. Radiology 171 : 841-845, 1989   DOI
2 Milhorat TH, Johnson WD, Miller JI, Bergland RM, Hollenberg-sher J : Surgical treatment of syringomyelia based on magnetic resonance imaging criteria. Neurosurgery 31 : 231-245, 1992   DOI
3 Nakamura M, Chiba K, Nishizawa T, Maruiwa H, Matsumoto M, Toyama Y : Retrospective study of surgery-related outcomes in patients with syringomyelia associated with Chiari I malformation : clinical significance of changes in the size and localization of syrinx on pain relief. J Neurosurg 100 : 241-244, 2004
4 Pojunas K, Williams AL, Daniels DL, Haughton VM : Syringomyelia and hydromyelia : magnetic resonance evaluation. Radiology 153 : 679- 683, 1984   DOI
5 Tator CH, Meguro K, Rowed DW : Favorable results with syringosubarachnoid shunts for treatment of syringomyelia. J Neurosurg 56 : 517- 523, 1982   DOI
6 Ergun R, Akdemir G, Gezici AR, Tezel K, Beskonakli E, Ergungor F, et al : Surgical management of syringomyelia-Chiari complex. Eur Spine J 9 : 553-557, 2000   DOI
7 Gardner WJ : Hydrodynamic mechanisms of syringomyelia : its relationship to myelocele. J Neurol Neurosurg Psychiatry 28 : 247-257, 1965   DOI
8 Lee BC, Zimmerman RD, Manning JJ, Deck MD : MR imaging of syringomyelia and hydromyelia. AJR Am J Roentgenol 144 : 1149-1156, 1985   DOI   ScienceOn
9 Vaquero J, Martinez R, Salazar J, Santos H : Syringosubarachnoid shunt for treatment of syringomyelia. Acta Neurochir (Wien) 84 : 105-109, 1987   DOI
10 Phillips TW, Kindt GW : Syringoperitoneal shunt for syringomyelia : a preliminary report. Surg Neurol 16 : 462-466, 1981   DOI   ScienceOn
11 Arruda JA, Costa CM, Tella Jr OI : Results of the treatment of syringomyelia associated with Chiari malformation : analysis of 60 cases. Arq Neuropsiquiatr 62 : 237-244, 2004   DOI   ScienceOn
12 Pillay PK, Awad IA, Hahn JF : Gardner's hydrodynamic theory of syringomyelia revisited. Cleve Clin J Med 59 : 373-380, 1992   DOI
13 Vaquero J, Martinez R, Arias A : Syringomyelia-Chiari complex : magnetic resonance imaging and clinical evaluation of surgical treatment. J Neurosurg 73 : 64-68, 1990   DOI
14 Attal N, Parker F, Tadie M, Aghakani N, Bouhassira D : Effects of surgery on the sensory deficits of syringomyelia and predictors of outcome : a long term prospective study. J Neurol Neurosurg Psychiatry 75 : 1025-1030, 2004   DOI
15 Grant R, Hadley DM, Lang D, Condon B, Johnston R, Bone I, et al : MRI measurement of syrinx size before and after operation. J Neurol Neurosurg Psychiatry 50 : 1685-1687, 1987   DOI
16 Terae S, Miyasaka K, Abe S, Abe H, Tashiro K : Increased pulsatile movement of the hindbrain in syringomyelia associated with the Chiari malformation : cine-MR with presaturation bolus tracking. Neuroradiology 36 : 125-129, 1994   DOI
17 Barbaro NM, Wilson CB, Gutin PH, Edward MB : Surgical treatment of syringomyelia. Favorable results with syringoperitoneal shunting. J Neurosurg 61 : 531-538, 1984   DOI
18 Kang MS, Park IS, Lee CH, Jung JM : Syringomyelia associated with posterior fossa arachnoid cyst. Case report. J Korean Neurosurg Soc 33 : 313-316, 2003
19 Williams B : A critical appraisal of posterior fossa surgery for communicating syringomyelia. Brain 101 : 223-250, 1978   DOI   ScienceOn
20 Gamache FW Jr, Ducker TB : Syringomyelia : a neurological and surgical spectrum. J Spinal Disord 3 : 293-298, 1990
21 Kim YS, Kim KN, Jin BH, Chung TS, Yoon DH, Cho YE, et al : The evaluation of prognosis in syringomyelia using SPAMM-MRI. J Korean Neurosurg Soc 28 : 13-20, 1999
22 Armonda RA, Citrin CM, Foley KT, Ellenbogen RG : Quantitative cinemode magnetic resonance imaging of Chiari I malformations : an analysis of cerebrospinal fluid dynamics. Neurosurgery 35 : 214-224, 1994   DOI   ScienceOn
23 Williams B : The distending force in the production of communicating syringomyelia. Lancet 2 : 189-193, 1969
24 Sherman JL, Barkovich AJ, Citrin CM : The MR appearance of syringomyelia : new observations. AJNR Am J Neuroradiol 7 : 985-995, 1986
25 Edelman RR, Mattle HP, Kleefield J, Silver MS : Quantification of blood flow with dynamic MR imaging and presaturation bolus tracking. Radiology 171 : 551-556, 1989   DOI
26 Bogdanov EI, Mendelevich EG : Syrinx size and duration of symptoms predict the pace of progressive myelopathy : retrospective analysis of 103 unoperated cases with craniocervical junction malformations and syringomyelia. Clin Neurol Neurosurg 104 : 90-97, 2002   DOI   ScienceOn
27 Hofmann E, Warmuth-Metz M, Bendszus M, Solymosi L : Phase-contrast MR imaging of the cervical CSF and spinal cord : volumetric motion analysis in patients with Chiari I malformation. AJNR Am J Neuroradiol 21 : 151-158, 2000
28 Lesoin F, Petit H, Thomas III CE, Viaud C, Baleriaux D, Jomin M : Use of the syringoperitoneal shunt in the treatment of syringomyelia. Surg Neurol 25 : 131-136, 1986   DOI   ScienceOn
29 Holly LT, Batzdorf U : Management of cerebellar ptosis following craniovertebral decompression for Chiari I malformation. J Neurosurg 94 : 21-26, 2001   DOI   ScienceOn
30 Iskandar BJ, Hedlund GL, Grabb PA, Oakes WJ : The resolution of syringohydromyelia without hindbrain herniation after posterior fossa decompression. J Neurosurg 89 : 212-216, 1998   DOI   ScienceOn
31 Wisoff JH, Epstein F : Management of hydromyelia. Neurosurgery 25 : 562-571, 1989   DOI
32 Hida K, Iwasaki Y, Koyanagi I, Sawamura Y, Abe H : Surgical indication and results of foramen magnum decompression versus syringosubarachnoid shunting for syringomyelia associated with Chiari I malformation. Neurosurgery 37 : 673-679, 1995   DOI   ScienceOn
33 Suzuki M, Davis C, Symon L, Gentili F : Syringoperitoneal shunt for treatment of cord cavitation. J Neurol Neurosurg Psychiatry 48 : 620-627, 1985   DOI