TY - JOUR
T1 - Surgical outcomes of posterior correction surgery for scoliosis associated with syringomyelia
AU - Tsuji, Osahiko
AU - Suzuki, Satoshi
AU - Takahashi, Yohei
AU - Nori, Satoshi
AU - Nagoshi, Narihito
AU - Okada, Eijiro
AU - Fujita, Nobuyuki
AU - Yagi, Mitsuru
AU - Nakamura, Masaya
AU - Matsumoto, Morio
AU - Watanabe, Kota
N1 - Funding Information:
The authors thank Makiko Miyazaki, Yukari Yamanishi, and Kie Wakita for their assistance. The final draft of this manuscript was edited by Francois Renault-Mihara (ClearBioEditing). This study was approved by the Ethics Committee of Keio University School of Medicine (approval number 20110222). We obtained written informed consent for the use of patient data from each patient or their guardian, according to the hospital's ethics guidelines.
Publisher Copyright:
© 2022 The Authors
PY - 2022/12
Y1 - 2022/12
N2 - Objective: Although syringomyelia is considered a risk factor for neurological complications of correction surgery for scoliosis, only a few reports on the surgical results of the correction surgery complicated with associated syringomyelia are available. The purpose of this study is to verify the potential risk of neurological complications due to the presence of syringomyelia and explore the factors affecting the surgical outcomes of posterior correction surgery for scoliosis associated with syringomyelia. Methods: This is a retrospective observational study in a single university hospital setting. Among 754 consecutive patients who underwent posterior correction and fusion surgery for scoliosis from 2009 through 2018 in our institution, we identified 28 patients presenting with spinal syringomyelia on preoperative whole spine MRI. The identified cases comprised 14 males and 14 females aged 11 years to 23 years (14.0 ± 2.9 years), and those with wide-type syrinx within fused spinal levels had undergone surgery for syringomyelia beforehand. First, we investigated the occurrence rate of peri- and postoperative neurological complications. Then we explored the factors affecting the correction rate of the Cobb angle and the incidence of coronal decompensation. Results: Neurological complication (transient sensory deficits in bilateral legs) occurred in one case with thoracic single curve and narrow-type syrinx, disappearing spontaneously within several weeks postoperatively. The cases with an L4 long curve (n = 3, including L4 in thoracolumbar long C-shaped curve) showed a significantly poor correction rate (38.7%, p = 0.003) and developed postoperative coronal decompensation. Conclusions: Prior treatment for wide-type syrinx located within the spinal fusion level effectively prevented severe neurological complications, and when treating cases with long-curve L4 scoliosis associated with syringomyelia, the surgeons should note the occurrence of postoperative coronal decompensation.
AB - Objective: Although syringomyelia is considered a risk factor for neurological complications of correction surgery for scoliosis, only a few reports on the surgical results of the correction surgery complicated with associated syringomyelia are available. The purpose of this study is to verify the potential risk of neurological complications due to the presence of syringomyelia and explore the factors affecting the surgical outcomes of posterior correction surgery for scoliosis associated with syringomyelia. Methods: This is a retrospective observational study in a single university hospital setting. Among 754 consecutive patients who underwent posterior correction and fusion surgery for scoliosis from 2009 through 2018 in our institution, we identified 28 patients presenting with spinal syringomyelia on preoperative whole spine MRI. The identified cases comprised 14 males and 14 females aged 11 years to 23 years (14.0 ± 2.9 years), and those with wide-type syrinx within fused spinal levels had undergone surgery for syringomyelia beforehand. First, we investigated the occurrence rate of peri- and postoperative neurological complications. Then we explored the factors affecting the correction rate of the Cobb angle and the incidence of coronal decompensation. Results: Neurological complication (transient sensory deficits in bilateral legs) occurred in one case with thoracic single curve and narrow-type syrinx, disappearing spontaneously within several weeks postoperatively. The cases with an L4 long curve (n = 3, including L4 in thoracolumbar long C-shaped curve) showed a significantly poor correction rate (38.7%, p = 0.003) and developed postoperative coronal decompensation. Conclusions: Prior treatment for wide-type syrinx located within the spinal fusion level effectively prevented severe neurological complications, and when treating cases with long-curve L4 scoliosis associated with syringomyelia, the surgeons should note the occurrence of postoperative coronal decompensation.
KW - Coronal decompensation
KW - Neurological complication
KW - Surgical outcome
KW - Syndromic scoliosis
KW - Syringomyelia
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U2 - 10.1016/j.inat.2022.101608
DO - 10.1016/j.inat.2022.101608
M3 - Article
AN - SCOPUS:85132842027
SN - 2214-7519
VL - 30
JO - Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
JF - Interdisciplinary Neurosurgery: Advanced Techniques and Case Management
M1 - 101608
ER -