Post-traumatic syringomyelia (cystic myelopathy): a prospective study of 449 patients with spinal cord injury.

Abstract

Objectives-To assess the incidence of post-traumatic syringomyelia (PTS) Materials and methods Four hundred and forty nine paraplegic and tetraplegic patients were admitted from within four hours to up to three weeks after injury and followed up up until 1 July 1994. Most of these patients had been seen clinically at least once a year. Conventional radiographs of the injured spine were performed before each MRI study. Kyphosis angle of the spine was measured taking the inferior end plate of the first unbroken vertebra above and below the fracture site. Kyphosis angles of the thoracic and thoracolumbar spine were then compared with normal values."' For the cervical spine all positive angles (kyphosis) were considered as abnormal as under normal conditions the cervical spine is in lordosis. In most patients MRI studies were carried out on the day of the trauma and thereafter yearly after diagnosis of PTS. Osteosynthesis material was removed whenever necessary to allow MRI examinations. In cases of surgical revision of the syrinx, MRI was performed six months after surgery and then yearly. Non-contrast MRI was done using either a 0-5, 1-0, or 1-5 T superconducting magnet. Spin echo images were obtained as TI weighted sagittal and axial planes and T2 weighted sagittal planes in most patients. Dual echo sagittal and coronal weighted images were sometimes also performed.

Post-traumatic syringomyelia and post-traumatic spinal canal stenosis: A direct relationship: Review of 75 patients with a spinal cord injury

“…The widely evoked role of persistent bony compression 8 ± 10 has been demonstrated in a recent study 5 which correlates the occurrence of syrinx in 20 cases with kyphosis. In the latter, 5 two patients with PTS underwent vertebral realignment, which was followed by collapse of the syrinxes.…”

“…In the latter, 5 two patients with PTS underwent vertebral realignment, which was followed by collapse of the syrinxes. Similarly, Sgouros and Williams 28 showed the e ectiveness in all cases of a laminectomy associated with opening of the subarachnoid space on the treatment of the syrinx.…”

“…3 The incidence of PTS is increasing and is evaluated di erently in the recent literature depending on whether it was diagnosed by clinical means (3.2%, 4 4.45%, 5 3.43% 6 ) or by neuroradiological examinations. 7 The unforseeable nature, and the seriousness of this complication, raise the problem of pathogenic mechanisms.…”

Factors associated with early onset post-traumatic syringomyelia

“…3 MRI has been found to be the most sensitive diagnostic imaging technique, and also yields information on the morphology of spinal cord cysts. On all imaging sequences, a spinal cord cyst should have a signal intensity equivalent to that of CSF.…”

“…Syringomyelia was first described by Bastian in 1867, 1 and, in 1880, Stru?mpell et al 2 reported instances of syringomyelia following spinal cord injury. 3 The clinical incidence of post-traumatic syringomyelia in patients with spinal cord injury has been estimated at 0.3-3.2%, although the incidence recorded radiologically and at autopsy appears to be higher than the clinical incidence. 4,5 The increased use of magnetic resonance imaging (MRI) for diagnosis has caused post-traumatic syringomyelia to be reported in 12-22% of patients with spinal cord injury.…”