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Chiari I malformation associated with syringomyelia: can foramen magnum decompression lead to restore cervical alignment?
Eur Spine J. 2013 Nov; 22(11):2520-5.ES

Abstract

PURPOSE

There are few researches that demonstrate the relationship between the extent of syringomyelia and sagittal alignment of the cervical spine. The purpose of this study is to investigate the correlation between the change of syrinx size and cervical alignment.

METHODS

From January 2001 to June 2008, we operated on 207 patients who had syringomyelia. The associated diseases were categorized by Chiari I malformation, tumor, trauma, spinal stenotic lesion, inflammatory disease and idiopathic causes. Thirty patients who had Chiari I malformation associated with syringomyelia and who underwent foramen magnum decompression (FMD), participated in this study. We excluded patients with scoliosis, cervical instrumentation, tumor, trauma, myelomeningocele, hydrocephalus, tethered cord and congenital vertebral anomalies. Lateral radiographs in neutral and magnetic resonance imaging were taken pre- and postoperatively.

RESULTS

Mean follow-up was 6.5 ± 1.5 years (ranged from 4.0 to 9.5 years). The mean pre- and postoperative lordosis angles at C2-C7 were -5.9° ± 1.0° and -10.4° ± 1.0°, respectively (P = 0.001). There was significant correlation between the differences of syrinx width and the cervical lordotic angles before and after surgery (P = 0.016). After FMD, syringomyelia and cervical alignment improved in 28 (93.3%) and 25 (85.18%) of 30 patients, respectively. There was significant correlation between recovery rate by Japanese Orthopaedic Association scores and the difference of the cervical lordotic angles before and after surgery (P = 0.022).

CONCLUSIONS

The present results demonstrate that the decrease of syrinx size by FMD may restore the cervical lordosis. We suggest that the postoperative cervical alignment might be a predictive factor for neurological outcome.

Authors+Show Affiliations

Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeonggi, 463-707, South Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23824287

Citation

Hyun, Seung Jae, et al. "Chiari I Malformation Associated With Syringomyelia: Can Foramen Magnum Decompression Lead to Restore Cervical Alignment?" European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, vol. 22, no. 11, 2013, pp. 2520-5.
Hyun SJ, Moon KY, Kwon JW, et al. Chiari I malformation associated with syringomyelia: can foramen magnum decompression lead to restore cervical alignment? Eur Spine J. 2013;22(11):2520-5.
Hyun, S. J., Moon, K. Y., Kwon, J. W., Lee, C. H., Kim, J., Kim, K. J., Jahng, T. A., Chung, C. K., & Kim, H. J. (2013). Chiari I malformation associated with syringomyelia: can foramen magnum decompression lead to restore cervical alignment? European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 22(11), 2520-5. https://doi.org/10.1007/s00586-013-2876-4
Hyun SJ, et al. Chiari I Malformation Associated With Syringomyelia: Can Foramen Magnum Decompression Lead to Restore Cervical Alignment. Eur Spine J. 2013;22(11):2520-5. PubMed PMID: 23824287.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Chiari I malformation associated with syringomyelia: can foramen magnum decompression lead to restore cervical alignment? AU - Hyun,Seung Jae, AU - Moon,Kyung Yun, AU - Kwon,Ji Woong, AU - Lee,Chang Hyun, AU - Kim,Jiha, AU - Kim,Ki-Jeong, AU - Jahng,Tae Ahn, AU - Chung,Chun Kee, AU - Kim,Hyun Jib, Y1 - 2013/07/04/ PY - 2012/11/20/received PY - 2013/06/15/accepted PY - 2013/04/15/revised PY - 2013/7/5/entrez PY - 2013/7/5/pubmed PY - 2014/12/30/medline SP - 2520 EP - 5 JF - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society JO - Eur Spine J VL - 22 IS - 11 N2 - PURPOSE: There are few researches that demonstrate the relationship between the extent of syringomyelia and sagittal alignment of the cervical spine. The purpose of this study is to investigate the correlation between the change of syrinx size and cervical alignment. METHODS: From January 2001 to June 2008, we operated on 207 patients who had syringomyelia. The associated diseases were categorized by Chiari I malformation, tumor, trauma, spinal stenotic lesion, inflammatory disease and idiopathic causes. Thirty patients who had Chiari I malformation associated with syringomyelia and who underwent foramen magnum decompression (FMD), participated in this study. We excluded patients with scoliosis, cervical instrumentation, tumor, trauma, myelomeningocele, hydrocephalus, tethered cord and congenital vertebral anomalies. Lateral radiographs in neutral and magnetic resonance imaging were taken pre- and postoperatively. RESULTS: Mean follow-up was 6.5 ± 1.5 years (ranged from 4.0 to 9.5 years). The mean pre- and postoperative lordosis angles at C2-C7 were -5.9° ± 1.0° and -10.4° ± 1.0°, respectively (P = 0.001). There was significant correlation between the differences of syrinx width and the cervical lordotic angles before and after surgery (P = 0.016). After FMD, syringomyelia and cervical alignment improved in 28 (93.3%) and 25 (85.18%) of 30 patients, respectively. There was significant correlation between recovery rate by Japanese Orthopaedic Association scores and the difference of the cervical lordotic angles before and after surgery (P = 0.022). CONCLUSIONS: The present results demonstrate that the decrease of syrinx size by FMD may restore the cervical lordosis. We suggest that the postoperative cervical alignment might be a predictive factor for neurological outcome. SN - 1432-0932 UR - https://www.unboundmedicine.com/medline/citation/23824287/Chiari_I_malformation_associated_with_syringomyelia:_can_foramen_magnum_decompression_lead_to_restore_cervical_alignment L2 - https://doi.org/10.1007/s00586-013-2876-4 DB - PRIME DP - Unbound Medicine ER -