LONG-TERM FOLLOW-UP OF CHIARI-RELATED SYRINGOMYELIA IN ADULTS
- 1 February 2009
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Neurosurgery
- Vol. 64 (2), 308-315
- https://doi.org/10.1227/01.neu.0000336768.95044.80
Abstract
To determine the long-term outcome of surgically treated Chiari-related syringomyelia. The medical charts of 157 consecutive surgically treated patients with Chiari-related syringomyelia were retrospectively analyzed. Factors predicting outcome, either clinical or radiological, are discussed, and our results are compared with those of other large series in the literature. The study included 74 men and 83 women (age range, 16-75 years; mean age at surgery, 38.3 years). Pain and sensory disturbance were the most frequent initial symptoms. The average duration of preoperative symptoms was 8.2 years. The follow-up period ranged from 82 to 204 months (median, 88 months). At the end of the study, 99 patients (63.06%) had improved, 48 (30.58%) had stabilized, 9 (5.73%) had worsened, and 1 (0.63%) had died during the postoperative period. Factors predicting improvement or stabilization were young age at the time of surgery and clinical signs of paroxysmal intracranial hypertension. Factors associated with a poor outcome were older age at the time of surgery, arachnoiditis, and a clinical feature of long-tract impairment syndrome. The presence of arachnoiditis or of basilar invagination was associated with poor clinical presentation (P = 0.05 and 0.0001, respectively). The extent of the cyst on postoperative magnetic resonance imaging was a predictor of poor clinical outcome (P = 0.002). Our results confirmed that surgery is an effective and safe treatment of Chiari-related syringomyelia, with a 90% chance of long-term stabilization or improvement on average. Surgery should be proposed as soon as possible in patients with clearly progressing clinical features.Keywords
This publication has 31 references indexed in Scilit:
- Surgical Treatment of Chiari I Malformation with or Without SyringomyeliaActa Neurochirurgica, 1999
- Syringomyelia Associated with Type I Chiari Malformation A 21-Year Retrospective Study on 75 Cases Treated by Foramen Magnum Decompression with a Special Emphasis on the Value of Tonsils ResectionActa Neurochirurgica, 1998
- The surgical treatment of Chiari I malformationActa Neurochirurgica, 1996
- Surgical Indication and Results of Foramen Magnum Decompression versus Syringosubarachnoid Shunting for Syringomyelia Associated with Chiari I MalformationNeurosurgery, 1995
- Quantitative Cine-mode Magnetic Resonance Imaging of Chiari I MalformationsNeurosurgery, 1994
- Chiari Malformation Presenting in Adults: A Surgical Experience in 127 CasesNeurosurgery, 1983
- Syringomyelia and its surgical treatment--an analysis of 75 patients.Journal of Neurology, Neurosurgery & Psychiatry, 1981
- Syringomyelia: long-term results after posterior fossa decompressionJournal of Neurosurgery, 1981
- The surgical treatment of syringomyelia. Long-term resultsActa Neurochirurgica, 1978
- PROGNOSIS OF SYRINGOMYELIAActa Neurologica Scandinavica, 1967