Posttraumatic syringomyelia: the British Columbia experience.

Area of Science:

• Neurosurgery
• Neurology
• Spinal Cord Injury Research

Background:

• Posttraumatic syringomyelia is an infrequent but significant late complication following spinal cord injury (SCI).
• Understanding its presentation, impact on function, and treatment outcomes is crucial for managing SCI patients.

Purpose of the Study:

• To identify patients with posttraumatic syringomyelia.
• To examine the initial presentation, neurological status, functional abilities, and treatment outcomes in these patients.
• To evaluate the effectiveness of conservative management versus surgical intervention (shunts).

Main Methods:

• Retrospective review of nine patients diagnosed with posttraumatic syringomyelia.
• Analysis of presenting symptoms, neurological deficits, and functional capacity.
• Comparison of outcomes between conservative management and surgical shunting (syringoperitoneal or syringosubarachnoid).

Main Results:

• Pain and numbness were the most common initial symptoms; motor impairment developed later and was more debilitating.
• Conservative management in three patients showed no significant progression of neurological deficits.
• Surgical shunting in six patients led to consistent pain improvement, with less notable gains in motor power and sensation; activities of daily living showed no significant change.

Conclusions:

• Posttraumatic syringomyelia presents a complex therapeutic challenge within the spinal cord injury population.
• While surgical shunts offer pain relief, significant improvements in motor function and sensation are less consistent.
• Conservative management may be a viable option for some patients, warranting further investigation.