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Spinal Obstruction-Related vs. Craniocervical Junction-Related Syringomyelia: A Comparative Study
Chenghua Yuan1,2,3,4,5, Jian Guan1,2,3,4,5, Yueqi Du1,2,3,4,5
1Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Frontiers in Neurology
|August 18, 2022
Summary
Post-traumatic syringomyelia (PTS) progresses faster than craniocervical junction (CCJ) syringomyelia, with more severe spinal cord injury (SCI). Peripheral blood inflammation markers, except RBC count, do not differentiate these conditions.
Area of Science:
- Neurosurgery
- Neurology
- Spinal Cord Injury Research
Background:
- Syringomyelia can cause spinal cord injury (SCI) by disrupting the blood-spinal cord barrier.
- No prior studies have compared SCI characteristics and inflammation in craniocervical junction (CCJ) syringomyelia versus post-traumatic syringomyelia (PTS).
Purpose of the Study:
- To investigate differences in SCI characteristics and inflammation between CCJ syringomyelia and PTS.
- To compare these factors before and after surgical decompression.
Main Methods:
- Analysis of 106 CCJ, 26 CCJ revision, and 15 PTS patients (2015-2019).
- Symptom course assessed using American Spinal Injury Association (ASIA) and Klekamp-Samii scoring.
- Neurological changes evaluated with Kaplan-Meier statistics.
Main Results:
- PTS had a longer interval post-injury but shorter syringomyelia history than CCJ.
- SCI was more severe in PTS, with cavities often at the thoracolumbar level and higher syrinx/cord ratio.
- No significant differences in long-term clinical efficacy or most peripheral blood inflammation markers (PBIMs) were observed, except for red blood cell (RBC) count.
Conclusions:
- Post-traumatic syringomyelia (PTS) demonstrates faster progression than CCJ-related syringomyelia.
- PBIMs, excluding RBC count, lack value in differentiating PTS and CCJ syringomyelia.
- Neutrophil-to-lymphocyte ratio has limited predictive value for syringomyelia-related inflammation outside the acute phase.
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