Syringohydromyelia following meningomyelocele surgery —role of metrizamide myelography and computed tomography

Stanley, Philip; Mo, Senac; Segall, H D; Ts, Park

doi:10.1007/bf01601875

Cited by 4 publications

(2 citation statements)

References 11 publications

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“…55 Particularly in adults, associated conditions may lead to spinal cord dysfunction when tethering is present. Degenerative spondylosis and spondylolisthesis, 9,35 hydromyelia, 10,36,47,49 and hydrocephalus 4 all can mimic TCS and/or worsen the condition of patients with this lesion.…”

Section: Scientific Foundationmentioning

confidence: 99%

Adult tethered cord syndrome in patients with postrepair myelomeningocele: an evidence-based outcome study

George

Fagan

2005

Journal of Neurosurgery

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Analysis of the available data indicates the following. (1) A lower lesion level predisposes patients to symptomatic tethering; moreover, orthopedic and urological deterioration will occur in the majority of these patients. (2) Tethered cord release should be considered for adult patients with postrepair myelomeningocele when clinical symptoms, imaging studies, urodynamics, and somatosensory evoked potentials are consistent with TCS. (3) Prompt, aggressive untethering surgery within 5 years of symptom onset, along with long-term follow up to check for delayed retethering, is recommended. The overall outcome for patients with postrepair myelomeningocele may not be as good as the outcome for adults with closed dysraphism.

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Section: Scientific Foundationmentioning

confidence: 99%

Adult tethered cord syndrome in patients with postrepair myelomeningocele: an evidence-based outcome study

George

Fagan

2005

Journal of Neurosurgery

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“…In other publications authors have described small clinical experiences with various treatment approaches. Stanley, et al, 40 described performing posterior cervical decompression with obex plugging in five children who presented with upper-limb weakness, including two with intrinsic hand-muscle atrophy. In all five cases surgery "halted the progression of the disease," but no patient was said to have improved.…”

Section: Treatment Of Syringomyeliamentioning

confidence: 99%

Syringomyelia complicating myelomeningocele: review of the evidence

Piatt¹

2004

Journal of Neurosurgery: Pediatrics

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Syringomyelia is frequently found in association with myelomeningocele. Although often asymptomatic, it can, in exceptional cases, cause severe morbidity. The author performed a structured literature review to address the following aspects of this clinical problem. What is the natural history? There are data concerning the imaging prevalence, the autopsy prevalence, and the prevalence of clinically active syringomyelia among patients with myelomeningocele, but literature provides no description of the course of this condition over time. What is the clinical significance? That correlations among symptoms, signs, treatments, and imaging findings are poorly described is no surprise in view of the large fraction of patients with syringomyelia who are asymptomatic. There is, however, an impressive mass of anecdotal evidence associating progressive syringomyelia with untreated (or inadequately treated) hydrocephalus. How to make the diagnosis? There is no disagreement that magnetic resonance imaging is the diagnostic modality of choice, but the literature provides very little guidance about who should undergo this investigation. There is no analysis of the costs and benefits of screening or periodic surveillance. What is the best treatment? Many surgical procedures have been reported to be useful as components of complex algorithms relating clinical factors and imaging data to treatment recommendations. There have been no controlled studies. There have been no prospective studies. There have been no multiinstitutional studies. No studies in which outcomes have been evaluated using objective, validated instruments. No studies in which the robustness of treatment effects over time have been documented. The complexity of treatment selection in contemporary practice makes syringomyelia unsuitable for randomized controlled trials of different therapies. Prospective cohort studies are feasible, however, and hold the potential to address many important questions about natural history and patient outcomes.

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Topical Review: Pediatric Syringomyelia

1994

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Syringomyelia was first recognized as a disease process some 400 years ago. The process of cystic dilation of the spinal cord is unpredictable and may result in a delay of many decades before the symptoms and signs of neurologic and orthopedic changes become apparent and commensurate with the observed cystic changes within the spinal cord. The syringomyelic process is usually associated with trauma, tumor, or congenital abnormalities at the craniocervical junction or along the spinal neuraxis. Several theories have been proposed as to processes involved in the development of spinal cyst formation, although none are completely compatible with the observed clinical pathology of syrinx development. Magnetic resonance imaging has markedly improved our ability to study the anatomy and natural history of syrinx formation, but to date, our understanding of the process remains imprecise. In view of the limited understanding of the pathophysiology of this disease process, it is not surprising that a variety of treatment regimens have been proposed and their efficacy remains difficult to fully evaluate.

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Syringohydromyelia following meningomyelocele surgery —role of metrizamide myelography and computed tomography

Cited by 4 publications

References 11 publications

Adult tethered cord syndrome in patients with postrepair myelomeningocele: an evidence-based outcome study

Adult tethered cord syndrome in patients with postrepair myelomeningocele: an evidence-based outcome study

Syringomyelia complicating myelomeningocele: review of the evidence

Topical Review: Pediatric Syringomyelia

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