Factors associated with early onset post-traumatic syringomyelia

Abstract

Study design: Retrospective study. Objectives: To identify factors associated with the development of early onset post-traumatic syringomyelia within 5 years of spinal cord injury. Setting: Department of Rehabilitation Medicine, Pusan National University School of Medicine, Korea. Methods: We retrospectively examined the records of 502 patients with traumatic cervical or thoracic spinal cord injury who underwent follow-up magnetic resonance imaging (MRI) examinations more than once a year for at least 5 years. Patients were assessed in terms of the neurological level of injury, the severity of initial spinal cord injury, the use of surgery and the extent of spinal canal involvement. The latter was evaluated by calculating the shortest antero-posterior diameter of the injured vertebral canal and the spinal reserve capacity as shown on MRI at the time of trauma onset and at the time of diagnosis of syringomyelia. Results: Syringomyelia developed within 5 years in 37 (7.3%) of the 502 patients. The mean age of these 37 patients was 44.6 years (range, 17-67 years) and the mean interval from spinal cord injury to onset of syringomyelia was 38.8 months (range, 2-54 months). The development of post-traumatic syringomyelia within 5 years was not significantly related to the severity or level of injury, the use of spinal surgery or the extent of spinal canal encroachment (PZ0.05 for each comparison). Conclusion: Early onset syringomyelia occurring within 5 years after spinal cord injury was not associated with neurological injury level, severity of injury, the use of spinal surgery or canal encroachment.

The characteristics of posttraumatic syringomyelia

“…Few authors have reported similar or lower (that is, 50-33%) proportions of patients with complete compared with those with incomplete SCI among patients suffering from syringomyelia. 2,9,10 In contrast to present and other results, Ko et al 2 have reported that only 49% of patients with early syringomyelia suffered from complete SCI.…”

“…This is in accordance with other investigations, in which there was no association between the injury level and the time to syrinx formation. 2,4,8 In contrast, some authors have observed a higher percentage of paraplegics among patients affected by syringomyelia. 9,10 In the present study, the time from SCI to syrinx formation was approximately 16 years in tetraplegic patients, compared with 7-9 years in previous reports.…”

“…1,2,8 Furthermore, it has been reported that the onset of posttraumatic syringomyelia is earlier with older age at the time of SCI and with cervical and thoracic SCI compared with lumbar SCI. 8 However, there is a lack of data concerning the relevant characteristics and risk factors of posttraumatic syringomyelia.…”

“…The incidence of posttraumatic syringomyelia with clinical manifestation ranges from o1% to 7%. [2][3][4][5]8,9 However, the incidence in radiological investigations is considerably higher and ranges 450%. 6,10,11 Clinically relevant posttraumatic syringomyelia does not occur frequently; nevertheless, progressive neurological deterioration in the wake of posttraumatic syringomyelia represents a serious complication with devastating consequences for the affected patients.…”

“…Sensory disturbance, gradual loss of motor function, pain at or above the level of injury and increased spasticity are the characteristic and most common clinical signs. [1][2][3][4][5][6][7] The reported incidences of posttraumatic syringomyelia vary greatly. The incidence of posttraumatic syringomyelia with clinical manifestation ranges from o1% to 7%.…”