[Features of syringomyelia natural course]

Area of Science:

• Neurology
• Neurosurgery
• Medical Science

Background:

• Syringomyelia (SM) is a rare condition with limited understanding of its natural progression and optimal treatment strategies.
• A lack of unified treatment concepts and continuity between neurologists and neurosurgeons complicates SM management.
• Objective data on surgical timing, goals, risks, and indications for SM are currently insufficient.

Purpose of the Study:

• To investigate the natural course of syringomyelia in patients not undergoing surgery.
• To determine the progression rate of SM, changes in cyst size, and their impact on patient condition.
• To identify the initial symptoms associated with disease progression in syringomyelia.

Main Methods:

• Retrospective analysis of medical records from 40 patients with syringomyelia who did not undergo surgery.
• Documentation of clinical manifestations at diagnosis and over the observation period.
• Correlation of symptom progression with cyst size changes observed via MRI.

Main Results:

• Of 28 symptomatic patients, 60.7% experienced symptom progression despite conservative treatment.
• In 28.6% of patients, symptoms remained stable; 10.7% showed improvement, with one case of cyst regression.
• Among 12 asymptomatic patients, only 8.3% developed progressing sensory disorders over a mean follow-up of 62 months.

Conclusions:

• Syringomyelia frequently progresses over time, even with conservative management.
• The natural history of SM varies, with some patients experiencing stable or improving conditions.
• Data from this study aid in defining objective indications for surgical intervention in syringomyelia.