| ORIGINAL ARTICLE
|Year : 2020 | Volume
| Issue : 2 | Page : 299--304
Surgical Treatment of Scoliosis-Associated with Syringomyelia: The Role of Syrinx Size
Ce Zhu1, Siqing Huang2, Yueming Song3, Hao Liu3, Limin Liu3, Xi Yang3, Chunguang Zhou3, Bowen Hu3, Haifeng Chen2
1 Department of Orthopedics Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu; Department of Spine Surgery, the Affiliated Hospital of Southwest Medical University, N0.25 Taiping Road, Luzhou, Sichuan, China
2 Department of Neurosurgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, China
3 Department of Orthopedics Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, China
Background: The treatment of the syrinx prior to correction of the scoliosis in syringomyelia-associated scoliosis (SMS) patients remains controversial. The aim of this study is to evaluate the role of the syrinx size in the management of SMS patients.
Materials and Methods: This was a retrospective study of 36 SMS patients. They were divided into 2 groups: Group A (26 with a small syrinx, syrinx(S)/spinal cord(C) ratio ≤0.7) and Group B (10 with a large syrinx, S/C ratio >0.7). Patients with a large syrinx accepted prophylactic neurosurgery prior to scoliosis surgery. They were evaluated at baseline, 1-week and last follow-up after correction surgery for changes in curve correction, global coronal balance, thoracic kyphosis (TK), sagittal vertical axis (SVA), and Scoliosis Research Society (SRS)-22 scores.
Results: The syrinx size of patients in Group A was significantly smaller than that of in Group B. The syrinx size was significantly decreased after prophylactic neurosurgery in Group B. The radiographic parameters of scoliosis at baseline, 1-week and last follow-up after scoliosis surgery were comparable between two groups. No abnormal signal was detected during the process of neuromonitoring in both groups. Pre- and postoperative SRS-22 scores were similar between two groups.
Conclusions: Prophylactic neurosurgery may be beneficial for decreasing the risk of correction surgery in SMS patients with large syrinx (S/C ratio >0.7). After the intervention of syrinx prior to scoliosis correction, SMS patients with large syrinx could obtain similar clinical and radiographic outcomes of treatment with pedicle-screw-based spinal instrumentation and fusion compared to the patients with small syrinx.
Dr. Limin Liu
Department of Orthopedics Surgery, West China Hospital, Sichuan University, No. 37 GuoXue Road, Chengdu, Sichuan, 610041
Source of Support: None, Conflict of Interest: None
[FULL TEXT] [PDF]*