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"Syringomyelia"

Original Articles

Spinal Cord Disorders

A Novel Clinical Insight Into Idiopathic Syringomyelia With Occult Arachnoid Webs: Neuropathological Features, Differential Diagnosis, and Surgical Strategy
Chunli Lu, Min Yin, Fan Yuan, Chenyuan Ding, Xingwen Wang, Fengzeng Jian
Neurospine 2025;22(3):846-858.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550278.139

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A Novel Clinical Insight Into Idiopathic Syringomyelia With Occult Arachnoid Webs: Neuropathological Features, Differential Diagnosis, and Surgical Strategy
Neurospine. 2025;22(3):846-858.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550278.139
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A Novel Clinical Insight Into Idiopathic Syringomyelia With Occult Arachnoid Webs: Neuropathological Features, Differential Diagnosis, and Surgical Strategy
Neurospine. 2025;22(3):846-858.   Published online September 30, 2025
DOI: https://doi.org/10.14245/ns.2550278.139
Close
Objective
Idiopathic syringomyelia (IS) associated with occult arachnoid pathology is a relatively rare condition characterized by a subtle onset, atypical clinical manifestations, and significant diagnostic and therapeutic challenges. This study aims to evaluate the radiographic and clinicopathological features of IS to improve surgical management and patient outcomes.
Methods
In this study, clinical and radiologic data were retrospectively extracted from a single-center syringomyelia database (N=1,039) spanning December 2020 to March 2025. Among these, 15 patients diagnosed with IS underwent preoperative magnetic resonance imaging and myelography to identify the responsible spinal segments precisely. Comprehensive perioperative assessments and clinical outcomes were collected. During surgery, the subarachnoid space (SAS) was thoroughly explored, with complete removal of thickened and adherent arachnoid tissue to restore normal cerebrospinal fluid (CSF) circulation. Additionally, clinical data, pathological features, and surgical outcomes of IS were compared to those of posttraumatic delayed syringomyelia (PTDS) to evaluate potential differences.
Results
In this series, all patients underwent preoperative myelography, revealing varying degrees of SAS obstruction. For IS cases that received precise and comprehensive arachnoid lysis, overall postoperative outcomes were favorable. Intraoperative pathology confirmed that all IS cases were characterized by noninfectious, nonacute inflammation. The preoperative maximal syrinx/cord ratio averaged 0.70±0.07 (range, 0.54–0.88), while the syrinx resolution rate varied from 12.2% to 100%, with a mean improvement of 29.6%. Patients with PTDS exhibited a relatively higher incidence of hypesthesia and a greater syrinx tension index. However, no significant differences were observed between IS and PTDS in terms of syrinx length, deviation, or location. Notably, the IS group demonstrated significantly better postoperative syrinx resolution and improvement in syringomyelia-related symptoms compared to the PTDS group.
Conclusion
While both IS and PTDS share a common underlying mechanism of arachnoid adhesions, they differ significantly in pathological features, treatment approaches, and clinical outcomes. In cases of IS, thorough spinal arachnoid lysis at the affected segment could restore normal spinal cord pulsation and CSF circulation, leading to effective syrinx resolution and a favorable long-term prognosis.

Citations

Citations to this article as recorded by  Crossref logo
  • The role of spinal cord pulsatility in the pathogenesis of Post-traumatic syringomyelia: A novel hypothesis
    Feifan Xu, Fengzeng Jian, Jian Guan, Zhiqiang Yi, Xingwen Wang
    Medical Hypotheses.2026; 209: 111924.     CrossRef
  • Extracellular Vesicle-Based Biomarkers in Spinal Cord Injury: A State-of-the-Art Review on Diagnostic and Prognostic Advances
    Trung Nhan Vo, Hae Eun Shin, Yeji Kim, Inbo Han
    International Journal of Molecular Sciences.2026; 27(4): 2079.     CrossRef
  • 5,915 View
  • 44 Download
  • 2 Web of Science
  • 2 Crossref

Regular Issue

Role of Preoperative Albumin Quotient in Surgical Planning for Posttraumatic Syringomyelia: A Comparative Cohort Study
Pingchuan Xia, Houyuan Lv, Chenghua Yuan, Wanru Duan, Jiachen Wang, Jian Guan, Yueqi Du, Can Zhang, Zhenlei Liu, Kai Wang, Zuowei Wang, Xingwen Wang, Hao Wu, Zan Chen, Fengzeng Jian
Neurospine 2024;21(1):212-222.   Published online February 1, 2024
DOI: https://doi.org/10.14245/ns.2347152.576

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Role of Preoperative Albumin Quotient in Surgical Planning for Posttraumatic Syringomyelia: A Comparative Cohort Study
Neurospine. 2024;21(1):212-222.   Published online February 1, 2024
DOI: https://doi.org/10.14245/ns.2347152.576
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Role of Preoperative Albumin Quotient in Surgical Planning for Posttraumatic Syringomyelia: A Comparative Cohort Study
Neurospine. 2024;21(1):212-222.   Published online February 1, 2024
DOI: https://doi.org/10.14245/ns.2347152.576
Close
Objective
Surgical procedures for patients with posttraumatic syringomyelia (PTS) remain controversial. Until now, there have been no effective quantitative evaluation methods to assist in selecting appropriate surgical plans before surgery.
Methods
We consecutively enrolled PTS patients (arachnoid lysis group, n = 42; shunting group, n = 14) from 2003 to 2023. Additionally, 19 intrathecal anesthesia patients were included in the control group. All patients with PTS underwent physical and neurological examinations and spinal magnetic resonance imaging preoperatively, 3–12 months postoperatively and during the last follow-up. Preoperative lumbar puncture was performed and blood-spinal cord barrier disruption was detected by quotient of albumin (Qalb, cerebrospinal fluid/serum).
Results
The ages (p = 0.324) and sex (p = 0.065) of the PTS and control groups did not differ significantly. There were also no significant differences in age (p = 0.216), routine blood data and prognosis (p = 0.399) between the arachnoid lysis and shunting groups. But the QAlb level of PTS patients was significantly higher than that of the control group (p < 0.001), and the shunting group had a significantly higher QAlb (p < 0.001) than the arachnoid lysis group. A high preoperative QAlb (odds ratio, 1.091; 95% confidence interval, 1.004–1.187; p = 0.041) was identified as the predictive factor for the shunting procedure, with the receiver operating characteristic curve showing 100% specificity and 80.95% sensitivity for patients with a QAlb > 12.67.
Conclusion
Preoperative QAlb is a significant predictive factor for the types of surgery. For PTS patients with a QAlb > 12.67, shunting represents the final recourse, necessitating the exploration and development of novel treatments for these patients.

Citations

Citations to this article as recorded by  Crossref logo
  • A novel Minimally-Invasive technique for Non-Traumatic postoperative adhesive Syringomyelia
    Can Zhang, Chenghua Yuan, Jiachen Wang, Hao Wu, Zan Chen, Fengzeng Jian, Jian Guan
    European Spine Journal.2026; 35(4): 2095.     CrossRef
  • Extracellular Vesicle-Based Biomarkers in Spinal Cord Injury: A State-of-the-Art Review on Diagnostic and Prognostic Advances
    Trung Nhan Vo, Hae Eun Shin, Yeji Kim, Inbo Han
    International Journal of Molecular Sciences.2026; 27(4): 2079.     CrossRef
  • 5,752 View
  • 119 Download
  • 3 Web of Science
  • 2 Crossref
The Physiological Occlusion of the Central Canal May Be a Prerequisite for Syringomyelia Formation
Chuan Jiang, Xinyu Wang, Chunli Lu, Qian Li, Longbing Ma, Wei Li, Shengyu Cui, Kang Li, Xiang Wang, Yuxin Feng, Fengzeng Jian
Neurospine 2023;20(4):1346-1357.   Published online December 31, 2023
DOI: https://doi.org/10.14245/ns.2346834.417

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The Physiological Occlusion of the Central Canal May Be a Prerequisite for Syringomyelia Formation
Neurospine. 2023;20(4):1346-1357.   Published online December 31, 2023
DOI: https://doi.org/10.14245/ns.2346834.417
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The Physiological Occlusion of the Central Canal May Be a Prerequisite for Syringomyelia Formation
Neurospine. 2023;20(4):1346-1357.   Published online December 31, 2023
DOI: https://doi.org/10.14245/ns.2346834.417
Close
Objective
Syringomyelia is a common central nervous system disease characterized by the dilation of the central canal (CC). Regarding the pathogenesis of syringomyelia, cerebrospinal fluid (CSF) circulation obstruction in the subarachnoid space (SAS) of the spinal cord has been widely accepted. However, clinical and animal studies on obstructing the CSF in SAS failed to form syringomyelia, challenging the theory of SAS obstruction. The precise pathogenesis remains unknown.
Methods
We utilized an extradural compression rat model to investigate the pathogenesis underlying syringomyelia. Magnetic resonance imaging enabled detection of syringomyelia formation. To assess CSF flow within the SAS, Evans blue was infused into the cisterna magna. Histological analysis allowed morphological examination of the CC. Furthermore, CSF flow through the CC was traced using Ovalbumin Alexa-Flour 647 conjugate (OAF-647). Scanning electron microscopy (SEM) enabled visualization of ependymal cilia.
Results
The findings showed that the dura mater below the compression segment exhibited lighter coloration relative to the region above the compression, indicative of partial obstruction within the SAS. However, the degree of SAS occlusion did not significantly differ between syringomyelia (SM-Y group) and those without (SM-N group). Intriguingly, hematoxylin and eosin staining and CSF tracing revealed occlusion of the CC accompanied by reduced CSF flow in the SM-Y group compared to SM-N and control groups. SEM images uncovered impairment of ependymal cilia inside the syringomyelia.
Conclusion
CC occlusion may represent a physiological prerequisite for syringomyelia formation, while SAS obstruction serves to initiate disease onset. The impairment of ependymal cilia appears to facilitate progression of syringomyelia.

Citations

Citations to this article as recorded by  Crossref logo
  • Glial scarring limits recovery following decompressive surgery in rats with syringomyelia
    Shengyu Cui, Jinze Li, Can Zhang, Qian Li, Chuan Jiang, Xinyu Wang, Xiaoxu Yu, Kang Li, Yuxin Feng, Fengzeng Jian
    Experimental Neurology.2025; 385: 115113.     CrossRef
  • Effectiveness of Cerebellar Tonsillectomy Treatment for Revision Chiari Malformation Surgery: A Series of 63 Patients
    Fan Yuan, Chenghua Yuan, Dingran Li, Pingchuan Xia, Jian Guan, Yueqi Du, Can Zhang, Zhenlei Liu, Kai Wang, Wanru Duan, Zuowei Wang, Xingwen Wang, Hao Wu, Zan Chen, Fengzeng Jian
    World Neurosurgery.2025; 196: 123690.     CrossRef
  • A Novel Surgical Technique for Post-traumatic Syringomyelia Progressing to the Medulla Oblongata: Evidence of Upward Drainage of Central Canal Fluid Within the Spinal Cord
    Chenghua Yuan, Zhencheng Xiong, Houyuan Lv, Chenyuan Ding, Pingchuan Xia, Huixin Xue, Hui Zhan, Mingchu Li, Yueqi Du, Can Zhang, Zhenlei Liu, Kai Wang, Wanru Duan, Zuowei Wang, Xingwen Wang, Hao Wu, Zan Chen, Fengzeng Jian, Jian Guan
    Neurosurgery.2025; 97(2): 424.     CrossRef
  • A novel Minimally-Invasive technique for Non-Traumatic postoperative adhesive Syringomyelia
    Can Zhang, Chenghua Yuan, Jiachen Wang, Hao Wu, Zan Chen, Fengzeng Jian, Jian Guan
    European Spine Journal.2025;[Epub]     CrossRef
  • 5,747 View
  • 158 Download
  • 5 Web of Science
  • 4 Crossref
Individualized Functional Decompression Options for Adult Chiari Malformation With Syringomyelia and A Novel Scale for Syringomyelia Resolution: A Single-Center Experience
Shiyuan Han, Bo Hou, Zhimin Li, Feng Feng, Yongning Li, Jun Gao
Neurospine 2023;20(4):1501-1512.   Published online December 31, 2023
DOI: https://doi.org/10.14245/ns.2346626.313

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Individualized Functional Decompression Options for Adult Chiari Malformation With Syringomyelia and A Novel Scale for Syringomyelia Resolution: A Single-Center Experience
Neurospine. 2023;20(4):1501-1512.   Published online December 31, 2023
DOI: https://doi.org/10.14245/ns.2346626.313
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Individualized Functional Decompression Options for Adult Chiari Malformation With Syringomyelia and A Novel Scale for Syringomyelia Resolution: A Single-Center Experience
Neurospine. 2023;20(4):1501-1512.   Published online December 31, 2023
DOI: https://doi.org/10.14245/ns.2346626.313
Close
Objective
To compare outcomes of posterior fossa bony decompression alone (PFD) versus PFD with duraplasty (PFDD) versus PFDD with additional obex exploration (PFDDO) in patients with Chiari malformation type I (CMI) combining syringomyelia.
Methods
Clinical records of adult patients who underwent decompressions from 2014 to 2022 were retrospectively analyzed. The decompression procedure was individualized based on the cerebrospinal fluid pulse in the surgical field. The Chicago Chiari Outcome Scale (CCOS) was used to assess the prognosis of the patients and a novel syringomyelia resolution scale, based on 3-dimensional volume, was introduced. The percentage change in the cervical syrinx volume was classified as follows by resolution: ≥ 70%, 30%–70%, and < 30%.
Results
Seventy-eight individuals were enrolled, of which 22, 20, and 36 underwent PFD, PFDD, and PFDDO, respectively. The three decompression groups had no significant difference in the preoperative characteristics and postoperative prognosis. Multivariate analyses revealed that better CCOS was significantly correlated with younger age at surgery (p = 0.018), syrinx originated from lower cervical levels (p = 0.037), narrower preoperative cerebral aqueduct (p = 0.005), and better syrinx volume resolution (p = 0.004). Additionally, a better cervical syrinx volume resolution was significantly correlated with higher CCOS (p = 0.017), narrower cerebral aqueduct (p = 0.035), and better tonsillar descent resolution (p = 0.007).
Conclusion
Individualized functional decompression induced an equal effect on CCOS and syrinx volume resolution for all CMI patients with syringomyelia. Our syringomyelia resolution scale facilitates communication and prediction of CMI prognosis.

Citations

Citations to this article as recorded by  Crossref logo
  • Cerebellar tonsil manipulation in Chiari malformation type I surgery: A systematic review and meta-analysis
    Guilherme L.O. Lima, Rui M.M. Deus, João Victor Massud, Derick Pedrosa Pachá, José Vitor Mota da Silva, Daniel Felipe Fernandes Paiva, Roger Schmidt Brock, Eberval Gadelha Figueiredo
    Clinical Neurology and Neurosurgery.2026; 261: 109264.     CrossRef
  • Integrated neuroimaging approach to the Chiari Malformation Spectrum from type 0 to 1.5: correlations between CSF flow impedance, tonsillar blackout sign, Obex position, and Clinico-anatomical features
    Leyla Salimli Mirzayeva, Murat Uçar, Emetullah Cindil, Sümeyye Nur Budak, Pelin Kuzucu
    Journal of Neuroradiology.2026; 53(2): 101527.     CrossRef
  • Clinical outcome of different surgical approaches for symptomatic Chiari malformation without syringomyelia: a 13-year retrospective study
    Qi-Shuai Yu, Teng Li, Ming Wan, Liang Zhang, Guang-Yu Qiao, Xin-Guang Yu, Yi-Heng Yin
    Neurosurgical Review.2025;[Epub]     CrossRef
  • Efficacy of neurosurgical intervention in syrinx resolution in patients presenting with Chiari malformation type I and syringomyelia: a systematic review and radiological meta-analysis
    Adharsh Suraj Prasad, Aqif Farhan bin Azmil Farid, Isaac Tang Jing Wen, Thomas Zhang, Chandrasekaran Kaliaperumal
    Neurosurgical Review.2025;[Epub]     CrossRef
  • 11,874 View
  • 402 Download
  • 5 Web of Science
  • 4 Crossref
Intra-articular Distraction Versus Decompression to Treat Basilar Invagination Without Atlantoaxial Dislocation: A Retrospective Cohort Study of 54 Patients
Boyan Zhang, Maoyang Qi, Zong Xin, Yueqi Du, Can Zhang, Zhenlei Liu, Jian Guan, Zuowei Wang, Fengzeng Jian, Wanru Duan, Zan Chen
Neurospine 2023;20(2):498-506.   Published online June 30, 2023
DOI: https://doi.org/10.14245/ns.2244910.455

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Intra-articular Distraction Versus Decompression to Treat Basilar Invagination Without Atlantoaxial Dislocation: A Retrospective Cohort Study of 54 Patients
Neurospine. 2023;20(2):498-506.   Published online June 30, 2023
DOI: https://doi.org/10.14245/ns.2244910.455
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Intra-articular Distraction Versus Decompression to Treat Basilar Invagination Without Atlantoaxial Dislocation: A Retrospective Cohort Study of 54 Patients
Neurospine. 2023;20(2):498-506.   Published online June 30, 2023
DOI: https://doi.org/10.14245/ns.2244910.455
Close
Objective
The surgical management of basilar invagination without atlantoaxial dislocation (type B basilar invagination) remains controversial. Hence, we have reported the use of posterior intra-articular C1–2 facet distraction, fixation, and cantilever technique versus foramen magnum decompression in treating type B basilar invagination as well as the results and surgical indications for this procedure.
Methods
This was a single-center retrospective cohort study. Fifty-four patients who underwent intra-articular distraction, fixation, and cantilever reduction (experimental group) and foramen magnum decompression (control group) were enrolled in this study. Distance from odontoid tip to Chamberlain’s line, clivus-canal angle, cervicomedullary angle, craniovertebral junction (CVJ) triangle area, width of subarachnoid space and syrinx were used for radiographic assessment. Japanese Orthopedic Association (JOA) scores and 12-item Short Form health survey (SF-12) scores were used for clinical assessment.
Results
All patients in the experimental group had a better reduction of basilar invagination and better relief of pressure on nerves. JOA scores and SF-12 scores also had better improvements in the experimental group postoperation. SF-12 score improvement was associated with preoperative CVJ triangle area (Pearson index, 0.515; p = 0.004), cutoff value of 2.00 cm2 indicating the surgical indication of our technique. No severe complications or infections occurred.
Conclusion
Posterior intra-articular C1–2 facet distraction, fixation, and cantilever reduction technique is an effective treatment for type B basilar invagination. As various factors involved, other treatment strategies should also be investigated.

Citations

Citations to this article as recorded by  Crossref logo
  • Posterior Only Reduction and Fixation of The Basilar Invagination and Atlantoaxial Dislocation Secondary to Severe Rheumatoid Arthritis: A Technical Note
    Sadegh Bagherzadeh, Faramarz Roohollahi, Morteza Faghih jouibari, Mohammad Jafari, Toufigh Mohaddes Javadi
    European Spine Journal.2026; 35(4): 1891.     CrossRef
  • Hot topics and trends in adult Chiari malformation and basilar invagination: a bibliometric analysis [2005–2025]
    Youhai Xin, Zeyu Xie, Yanchun Guo, Zhesheng Chen, Weiwu Zheng, Wen Zhou, Zibi Xu, Weida Hong, Qinguo Huang
    Egyptian Journal of Neurosurgery.2026;[Epub]     CrossRef
  • A Surgical Technique Guide for C1–2 Fixation By the Cervical Spine Research Society
    Marc Prablek, Ashel C. Dsouza, Brian W. Su, Lee A. Tan
    Clinical Spine Surgery.2026;[Epub]     CrossRef
  • Impact of Additional Tonsillar Manipulation or Intra-articular Distraction on Syrinx Remission for Type B Basilar Invagination
    Qiang Jian, Zhe Hou, Xingang Zhao, Cong Liang, Yinqian Wang, Dongao Zhang, Kun Wu, Jichao Wang, Tao Fan
    Neurosurgery.2026;[Epub]     CrossRef
  • C2 Vertebra: An Enigma for Young Spine/Neurosurgeons
    Mayank Garg, Raghavendra K. Sharma, Vikas Janu, Mohit Agrawal, Ashutosh Jha, Pushpinder Khera, Deepak K. Jha
    Journal of Neurological Surgery Part B: Skull Base.2025; 86(01): 092.     CrossRef
  • Surgical Treatment of Basilar Invagination
    Ricardo V. Botelho, Oscar L. Alves, Geraldo Sá Carneiro, Zan Chen, Onur Yaman, Jutty Parthiban, Massimiliano Visocchi, Jörg Klekamp, Atul Goel, Mehmet Zileli
    Spine.2025; 50(11): 751.     CrossRef
  • Surgical Treatment of Basilar Invagination without Evident Atlantoaxial Instability (Type B) - A Systematic Review
    Andrei Fernandes Joaquim, Eloy Rusafa Neto, Leon Cleres Penido Pinheiro, Osmar Jose Santos de sMoraes, Eberval Gadelha Figueiredo, Carlos Gilberto Carloti, Roger Schimdt Brock
    Neurology India.2025; 73(3): 423.     CrossRef
  • Analysis of Failed Atlantoaxial Reduction: Causes of Failure and Strategies for Revision
    Boyan Zhang, Yueqi Du, Can Zhang, Maoyang Qi, Hongfeng Meng, Tianyu Jin, Guoqing Cui, Jian Guan, Wanru Duan, Zan Chen
    Orthopaedic Surgery.2024; 16(11): 2741.     CrossRef
  • Biomechanical Study of Atlanto-occipital Instability in Type II Basilar Invagination: A Finite Element Analysis
    Junhua Ye, Qinguo Huang, Qiang Zhou, Hong Li, Lin Peng, Songtao Qi, Yuntao Lu
    Neurospine.2024; 21(3): 1014.     CrossRef
  • From the Editor-in-Chief: Featured Articles in the June 2023 Issue
    Inbo Han
    Neurospine.2023; 20(2): 413.     CrossRef
  • 6,948 View
  • 230 Download
  • 8 Web of Science
  • 10 Crossref

Regular Issue

Relationship Between Syrinx Resolution and Cervical Sagittal Realignment Following Decompression Surgery for Chiari I Malformation Related Syringomyelia Based on Configuration Phenotypes
Chunli Lu, Longbing Ma, Jian Guan, Zhenlei Liu, Kai Wang, Wanru Duan, Zan Chen, Hao Wu, Fengzeng Jian
Neurospine 2022;19(4):1057-1070.   Published online December 31, 2022
DOI: https://doi.org/10.14245/ns.2244530.265

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Relationship Between Syrinx Resolution and Cervical Sagittal Realignment Following Decompression Surgery for Chiari I Malformation Related Syringomyelia Based on Configuration Phenotypes
Neurospine. 2022;19(4):1057-1070.   Published online December 31, 2022
DOI: https://doi.org/10.14245/ns.2244530.265
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Relationship Between Syrinx Resolution and Cervical Sagittal Realignment Following Decompression Surgery for Chiari I Malformation Related Syringomyelia Based on Configuration Phenotypes
Neurospine. 2022;19(4):1057-1070.   Published online December 31, 2022
DOI: https://doi.org/10.14245/ns.2244530.265
Close
Objective
Combined with different configuration types of syringomyelia, to analyze the correlation between syrinx resolution and changes in cervical sagittal alignment following Foramen magnum and Magendie dredging (FMMD) for syringomyelia associated with Chiari I malformation (CM-I), and to further explore the respective relationship with clinical outcome.
Methods
A consecutive series of 127 patients with CM-I and syringomyelia who underwent FMMD in our center met the inclusion criteria of this study. Their clinical records and radiologic data were retrospectively reviewed. The Japanese Orthopedic Association (JOA) scoring system and the Chicago Chiari Outcome Scale (CCOS) were used to evaluate the surgical efficacy. The phenotypes of syringomyelia and the clinical characteristics of the patients were analyzed according to grouping by cervical curvature at baseline.
Results
The preoperative straight or kyphotic cervical alignment is more common in the moniliform syrinx. After surgery, the syrinx resolution and cervical sagittal realignment in the moniliform group are more obvious, and the corresponding prognosis is relatively better. Spearman correlation analysis showed that the ΔS/C ratio (the change ratio of syrinx/cord) was positively correlated with the CCOS (p = 0.001, r = 0.897) and ΔC2–7A (the change of lower cervical angle) (p = 0.002, r = 0.560). There was also a correlation between the ΔJOA score (the change rate of the JOA score) and ΔC2–7A (p = 0.012, r = 0.467).
Conclusion
After decompression surgery, syrinx resolution may coexist with the changes in the subaxial lordosis angle, especially for syrinx in moniliform type, and the relationship between syrinx resolution and cervical sagittal realignment might be valuable for evaluating the surgical outcome.

Citations

Citations to this article as recorded by  Crossref logo
  • Efficacy of neurosurgical intervention in syrinx resolution in patients presenting with Chiari malformation type I and syringomyelia: a systematic review and radiological meta-analysis
    Adharsh Suraj Prasad, Aqif Farhan bin Azmil Farid, Isaac Tang Jing Wen, Thomas Zhang, Chandrasekaran Kaliaperumal
    Neurosurgical Review.2025;[Epub]     CrossRef
  • Correlation Among Syrinx Resolution, Cervical Sagittal Realignment, and Surgical Outcome After Posterior Reduction for Basilar Invagination, Atlantoaxial Dislocation, and Syringomyelia
    Chunli Lu, Wanru Duan, Can Zhang, Yueqi Du, Xinyu Wang, Longbing Ma, Kai Wang, Hao Wu, Zan Chen, Fengzeng Jian
    Operative Neurosurgery.2023; 25(2): 125.     CrossRef
  • Individualized Functional Decompression Options for Adult Chiari Malformation With Syringomyelia and A Novel Scale for Syringomyelia Resolution: A Single-Center Experience
    Shiyuan Han, Bo Hou, Zhimin Li, Feng Feng, Yongning Li, Jun Gao
    Neurospine.2023; 20(4): 1501.     CrossRef
  • 9,416 View
  • 168 Download
  • 4 Web of Science
  • 3 Crossref
Phenotypes and Prognostic Factors of Syringomyelia in Single-Center Patients With Chiari I Malformation: Moniliform Type as a Special Configuration
Chunli Lu, Longbing Ma, Chenghua Yuan, Lei Cheng, Xinyu Wang, Wanru Duan, Kai Wang, Zan Chen, Hao Wu, Gao Zeng, Fengzeng Jian
Neurospine 2022;19(3):816-827.   Published online September 30, 2022
DOI: https://doi.org/10.14245/ns.2244332.166

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Phenotypes and Prognostic Factors of Syringomyelia in Single-Center Patients With Chiari I Malformation: Moniliform Type as a Special Configuration
Neurospine. 2022;19(3):816-827.   Published online September 30, 2022
DOI: https://doi.org/10.14245/ns.2244332.166
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Phenotypes and Prognostic Factors of Syringomyelia in Single-Center Patients With Chiari I Malformation: Moniliform Type as a Special Configuration
Neurospine. 2022;19(3):816-827.   Published online September 30, 2022
DOI: https://doi.org/10.14245/ns.2244332.166
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Objective
The specific association between morphometric characteristics of the syrinx and the prognosis of Chiari malformation type I (CM-I) with syringomyelia following surgical procedure seems to have not been fully elaborated. This study focused on the preoperative clinical and radiologic parameters in CM-I patients with syringomyelia to find out the relationship between the patients’ clinical status and the phenotypes of the syrinx with surgical outcome.
Methods
A continuous series of pediatric and adult patients with CM-I and syringomyelia from a prospectively maintained database in a single center were included, and we explored the related factors affecting the prognosis following decompression surgery through retrospective analysis of clinical presentations, imaging characteristics, and the morphological features of syringomyelia, to provide a clinical reference for the treatment of syringomyelia.
Results
There were 28 pediatric patients (13.8%), and 174 adults (86.2%) included in our study. The average Chicago Chiari Outcome Scale score was 14.56 ± 1.78. The overall prognosis after surgery was good in our series, among them 152 cases (75.25%) with a favorable prognosis, and syrinx was resolved effectively in 172 cases (85.15%). According to the univariate and multivariate analyses, the preoperative symptom duration, observation time, and with/without moniliform type were independent factors affecting the prognosis in adults. The most obvious difference between moniliform type and nonmoniliform type lies in the preoperative symptom duration, ventral subarachnoid space at the foramen magnum, and with/without straightened cervical physio-curve.
Conclusion
Timely decompression surgery could achieve a better outcome in CM-I patients with syringomyelia. Moniliform syringomyelia may suggest a relatively better prognosis.

Citations

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  • Chiari 1 Malformation, Factors That May Influence Decision Making, and Introducing the Chiari 1 Malformation Severity Classification System
    Stuart Holder, Muath Abdelkarim Abbakr, Amelia Haynes, Taofiq Desmond Sanusi
    Journal of Clinical Medicine.2025; 14(17): 6113.     CrossRef
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    Adharsh Suraj Prasad, Aqif Farhan bin Azmil Farid, Isaac Tang Jing Wen, Thomas Zhang, Chandrasekaran Kaliaperumal
    Neurosurgical Review.2025;[Epub]     CrossRef
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    Ethan D.L. Brown, Apratim Maity, Max Ward, Daniel Toscano, Griffin R. Baum, Mark A. Mittler, Sheng-Fu Larry Lo, Randy S. D'Amico
    World Neurosurgery.2024; 191: e304.     CrossRef
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    Chunli Lu, Jian Guan, Chenyuan Ding, Xingwen Wang, Zuowei Wang, Zan Chen, Hao Wu, Fengzeng Jian
    Acta Neurologica Belgica.2023; 123(3): 1061.     CrossRef
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  • The Physiological Occlusion of the Central Canal May Be a Prerequisite for Syringomyelia Formation
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  • 8 Web of Science
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Case Report

Anterior Spinal Cord Fissuring: A Predictor of Spontaneous Resolution of Syrinx?
Kartik Manoj Multani, Boyina Jagadeshwar Rajesh, Krishna Kumar, Anjani Kumar
Neurospine 2021;18(1):240-244.   Published online November 17, 2020
DOI: https://doi.org/10.14245/ns.2040308.154

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Anterior Spinal Cord Fissuring: A Predictor of Spontaneous Resolution of Syrinx?
Neurospine. 2021;18(1):240-244.   Published online November 17, 2020
DOI: https://doi.org/10.14245/ns.2040308.154
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Anterior Spinal Cord Fissuring: A Predictor of Spontaneous Resolution of Syrinx?
Neurospine. 2021;18(1):240-244.   Published online November 17, 2020
DOI: https://doi.org/10.14245/ns.2040308.154
Close
Syringomyelia is a disorder of the spinal cord usually seen in association with a variety of craniovertebral junction anomalies (e.g. , Chiari malformations, basilar invagination/impression, atlantoaxial instability, etc.). Its natural history is not very clearly understood and a majority of patients present with a slowly progressive neurological deficit followed by sudden rapid deterioration. At present, there is a general consensus to offer surgical decompression in all patients diagnosed with Chiari I malformation with syrinx irrespective of their symptoms in order to prevent delayed neurological worsening. Few authors have reported spontaneous resolution of syrinx with persistent tonsillar herniation without operative treatment. We report one such patient and propose anterior spinal cord fissuring as a plausible cause of spontaneous syrinx drainage. We also propose conservative management for patients with an anterior spinal cord fissure seen in index scans instead of early decompression of Chiari malformation.

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  • Syrinx reduction due to spontaneous spinal cord tear: demonstration on 3 T MRI and review of the literature
    Serena Staglianó, Elena Prodi, Barbara Goeggel Simonetti, Alessandro Cianfoni
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  • Syringomyelia intermittens: highlighting the complex pathophysiology of syringomyelia. Illustrative case
    Jorn Van Der Veken, Marguerite Harding, Saba Hatami, Marc Agzarian, Nick Vrodos
    Journal of Neurosurgery: Case Lessons.2021;[Epub]     CrossRef
  • 9,287 View
  • 290 Download
  • 2 Web of Science
  • 2 Crossref

Review Article

APCSS special Topic-Craniovertebral Junction Surgery

A Review of a New Clinical Entity of ‘Central Atlantoaxial Instability’: Expanding Horizons of Craniovertebral Junction Surgery
Atul Goel
Neurospine 2019;16(2):186-194.   Published online June 30, 2019
DOI: https://doi.org/10.14245/ns.1938138.069

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A Review of a New Clinical Entity of ‘Central Atlantoaxial Instability’: Expanding Horizons of Craniovertebral Junction Surgery
Neurospine. 2019;16(2):186-194.   Published online June 30, 2019
DOI: https://doi.org/10.14245/ns.1938138.069
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A Review of a New Clinical Entity of ‘Central Atlantoaxial Instability’: Expanding Horizons of Craniovertebral Junction Surgery
Neurospine. 2019;16(2):186-194.   Published online June 30, 2019
DOI: https://doi.org/10.14245/ns.1938138.069
Close
The author discusses the novel form of central or axial atlantoaxial instability and analyses its clinical significance. High degree of clinical and radiological understanding of the region is mandatory to diagnose and then treat such atlantoaxial instability. Evaluation of alignment of facets of atlas and axis and observations on direct manipulation of facets of atlas and axis forms the basis of diagnosis. The treatment of clinical entities like basilar invagination, Chiari formation, syringomyelia and myelopathy related to cervical spinal degeneration, spinal deformities, ossified posterior longitudinal ligament, and Hirayama disease can be influenced by the understanding of central or axial atlantoaxial instability.

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Original Article

Neural Axis Abnormalities in Patients With Adolescent Idiopathic Scoliosis: Is Routine Magnetic Resonance Imaging Indicated Irrespective of Curve Severity?
Sidsel Fruergaard, Søren Ohrt-Nissen, Benny Dahl, Nicolai Kaltoft, Martin Gehrchen
Neurospine 2019;16(2):339-346.   Published online October 15, 2018
DOI: https://doi.org/10.14245/ns.1836154.077

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Neural Axis Abnormalities in Patients With Adolescent Idiopathic Scoliosis: Is Routine Magnetic Resonance Imaging Indicated Irrespective of Curve Severity?
Neurospine. 2019;16(2):339-346.   Published online October 15, 2018
DOI: https://doi.org/10.14245/ns.1836154.077
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Neural Axis Abnormalities in Patients With Adolescent Idiopathic Scoliosis: Is Routine Magnetic Resonance Imaging Indicated Irrespective of Curve Severity?
Neurospine. 2019;16(2):339-346.   Published online October 15, 2018
DOI: https://doi.org/10.14245/ns.1836154.077
Close
Objective
Magnetic resonance imaging (MRI)-verified neural axis abnormalities (NAAs) have been described in adolescent idiopathic scoliosis (AIS), and several risk factors have been associated with the presence of NAAs in AIS patients. However, the clinical significance of these findings is unclear. The purpose of the present study was to determine the prevalence of NAAs in a large consecutive cohort of AIS patients and to evaluate the clinical significance of previously proposed risk factors.
Methods
We prospectively included AIS patients referred to a tertiary facility for evaluation. Full-spine MRI scans were performed on all included patients irrespective of curve magnitude or proposed treatment modality. MRI scans were prospectively analyzed by a neuroradiologist and the pathologic findings were confirmed by a second independent radiologist.
Results
NAA was observed in 34 of the 381 patients (8.9%): 32 patients had a syrinx, 1 patient had an arachnoid cyst, and 1 patient had a Chiari malformation. Four patients were referred for a neurosurgical evaluation but none received any neurosurgical treatment. No statistically significant difference was observed between the NAA and non-NAA groups in terms of sex, major curve size, thoracic kyphosis, left thoracic curve, curve convexity, curve progression, or level of pain (p>0.05).
Conclusion
In this prospective study examining the risk factors for NAA in AIS patients, we found that previously proposed risk factors could not predict the MRI outcomes. The finding of an NAA had no clinical implications and we do not support MRI scans as a routine diagnostic modality in all AIS patients.

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    Asian Spine Journal.2025; 19(5): 708.     CrossRef
  • Evaluation of forces on muscles and intervertebral joints during active kyphosis-deepening exercises in the dynamic individual stimulation and control for spine device (DISC4SPINE, D4S): a modeling approach—proof of concept study
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    Frontiers in Sports and Active Living.2025;[Epub]     CrossRef
  • Total spine MRI for the preoperative evaluation of adolescent idiopathic scoliosis: part 1
    Hyojeong Lee, Fatima Janjua, Ahmed Ragab, Jay Moran, Andrew Haims, Daniel Rubio, Dominick Tuason, Jack Porrino
    Current Problems in Diagnostic Radiology.2024; 53(3): 405.     CrossRef
  • HIDDEN NEURAXIAL PATHOLOGY IN IDIOPATHIC SCOLIOSIS: ORIGINAL RESEARCH
    Olga M. Sergeenko, Dmitry M. Savin, Anna A. Pozdeyeva, Marat S. Saifutdinov, Yuri V. Molotkov, Konstantin A. Diachkov
    Coluna/Columna.2024;[Epub]     CrossRef
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    Journal of Clinical Medicine.2024; 13(24): 7746.     CrossRef
  • Neuromuscular disturbances in adolescent idiopathic scoliosis observed from the anticipatory muscle activations in scapula stabilizers: a cross-sectional study
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    BMC Musculoskeletal Disorders.2024;[Epub]     CrossRef
  • Spine Deformity Associated with Chiari I Malformation and Syringomyelia
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  • Does magnetic resonance imaging impact pre-operative plans in adolescent idiopathic scoliosis patients? A retrospective study
    Suhail S. Al Assiri, Sami I. Al Eissa, Faisal M. Konbaz, Fahad H. Al Helal, Majed S. Abaalkhail, Mohammed J. AlSalman, Rayed M. Al Jehani, Abdullah F. Mohabbat
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  • 12,577 View
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Case Reports

Syringomyelia Associated with a Huge Retrocerebellar Arachnoid Cyst: A Case Report
Sung Baek Hue, Han Yu Seong, Soon Chan Kwon, In Uk Lyo, Hong Bo Sim
Korean J Spine 2015;12(3):156-159.   Published online September 30, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.3.156

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Syringomyelia Associated with a Huge Retrocerebellar Arachnoid Cyst: A Case Report
Korean J Spine. 2015;12(3):156-159.   Published online September 30, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.3.156
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Syringomyelia Associated with a Huge Retrocerebellar Arachnoid Cyst: A Case Report
Korean J Spine. 2015;12(3):156-159.   Published online September 30, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.3.156
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Occasionally, a posterior fossa arachnoid cyst can induce compression of the spinal cord and cause syringomyelia. Here, we report the case of a 29-year-old man with both progressive shoulder pain and gait disturbance, who was found to have a huge retrocerebellar arachnoid cyst associated with syringomyelia. Accordingly, posterior fossa decompression and arachnoid cyst excision were performed. Post-operative MRI showed a marked reduction in the size of the arachnoid cyst and syringomyelia. The patient's symptoms were clearly improved compared to before surgery. In our view, treatment in such patients should focus on decompressing the foramen magnum and include the removal of the coexistent arachnoid cyst walls, which appear to be the crucial factor in development of syringomyelia. In this report, we discuss the pathogenic mechanisms underlying syringomyelia-associated retrocerebellar arachnoid cyst and review the current literature on this topic.

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  • Endoscopic fenestration of a posterior fossa arachnoid cyst to treat a Chiari-like headache
    Matteo Vitali, Andrea Cattalani, Vincenzo M. Grasso, Alessandro Bertuccio, Andrea Barbanera
    Journal of Neurosurgical Sciences.2020;[Epub]     CrossRef
  • Acquired Chiari Malformation and Syringomyelia Secondary to Space-Occupying Lesions: A Systematic Review
    Justin Wang, Naif M. Alotaibi, Nardin Samuel, George M. Ibrahim, Aria Fallah, Michael D. Cusimano
    World Neurosurgery.2017; 98: 800.     CrossRef
  • 10,769 View
  • 118 Download
  • 2 Crossref
Intradural Extramedullary Tuberculoma of the Spinal Cord Following Tuberculous Meningitis
Deok-Ki Jeong, Young-Min Kwon
Korean J Spine 2015;12(2):107-110.   Published online June 30, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.2.107

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Intradural Extramedullary Tuberculoma of the Spinal Cord Following Tuberculous Meningitis
Korean J Spine. 2015;12(2):107-110.   Published online June 30, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.2.107
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Intradural Extramedullary Tuberculoma of the Spinal Cord Following Tuberculous Meningitis
Korean J Spine. 2015;12(2):107-110.   Published online June 30, 2015
DOI: https://doi.org/10.14245/kjs.2015.12.2.107
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Intradural extramedullary tuberculoma of the spinal cord (IETSC) is an uncommon disease which can occurs secondary to tuberculous meningitis. A 31-year-old woman was diagnosed as tuberculous meningitis after mental disorientation. Her mentality was recovered after antituberculous therapy. After 7 months of antituberculous therapy, paraplegia has developed. Magnetic resonance imaging (MRI) revealed a mass lesion between the T1 and T12 spinal levels with arachnoid thickening which results in the development of tuberculoma. She received surgical resection of IETSC followed by antituberculous therapy and neurological function has been improved. The two years after surgical treatment, spinal MRI showed syringomyelia between T1 to L1. But, her neurological outcome was not aggravated.

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  • Isolated Intradural Extramedullary Tuberculoma Causing Paraplegia in an Immunocompetent Child: A Case Report and Review of the Literature
    Oumar Coulibaly, Mahamadou Dama, Daouda Sissoko, Diankading Sissoko, Youssouf Sogoba, Moussa Diallo, Mamadou Salia Diarra, Drissa Kanikomo, Oumar Diallo
    World Journal of Neuroscience.2025; 15(03): 240.     CrossRef
  • Delayed Presentation of Intradural Extramedullary Tuberculoma of Spine in an Immunocompetent MDR-TB Patient
    Nishant Saurabh, Vetri Nallathambi
    Indian Spine Journal.2024; 7(2): 203.     CrossRef
  • Mycobacterium bovis Granulomatous Pachymeningitis after Intravesical BCG Immunotherapy
    Sevcan Turk, John Kim
    Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.2022; 49(2): 274.     CrossRef
  • Multisegment Extradural Tuberculoma Masquerading as a Spinal Tumor
    Rishika Trivedi, Pankaj Trivedi, Rekha Gupta
    Cureus.2022;[Epub]     CrossRef
  • Intradural extramedullary tuberculoma of the spinal cord mimicking meningioma
    Ayesha Arif Ansari, Paresh Korde, Sandeep W Iratwar, Ashish Anjankar
    BMJ Case Reports.2022; 15(12): e253040.     CrossRef
  • Intradural extramedullary tuberculoma of the thoracic spine – A rare case report of paraparesis
    Boris Kangabam, Thokchom Amataleima, Mayanglambam Amitkumar, Takhelmayum Umesh
    Surgical Neurology International.2021; 12: 136.     CrossRef
  • Intradural extramedullary tuberculoma of the spinal cord in patient of tubercular meningitis - an uncommon scenario
    Harleen Kaur, Gaurav Kumar Mittal, Jennifer Singhdev
    Indian Journal of Tuberculosis.2020; 67(3): 426.     CrossRef
  • Tetraplegia associated with post-operative syringomyelia in spinal tuberculosis: a result of an epidural compartment syndrome?
    Nishit Bhatnagar, Ankit Kataria, Purushotham Lingaiah, Yugal Karkhur
    Spinal Cord Series and Cases.2019;[Epub]     CrossRef
  • Posttubercular syringomyelia in HIV-infected patients: A report of 10 cases and literature review
    Suzaan Marais, Izanne Roos, Ayesha Mitha, Vinod Patel, Ahmed I. Bhigjee
    Journal of the Neurological Sciences.2018; 395: 54.     CrossRef
  • Intradural extramedullary tuberculoma masquerading en plaque meningioma
    Manchikanti Venkatesh, Pentyala Suneetha, Veldurti Kumar, Vissa Santhi, Luis Moscote-Salazar, Amit Agrawal
    Asian Journal of Neurosurgery.2018; 13(03): 928.     CrossRef
  • 10,502 View
  • 97 Download
  • 10 Crossref
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