Frontiers in Neurology (Aug 2022)

Spinal Obstruction-Related vs. Craniocervical Junction-Related Syringomyelia: A Comparative Study

  • Chenghua Yuan,
  • Chenghua Yuan,
  • Chenghua Yuan,
  • Chenghua Yuan,
  • Chenghua Yuan,
  • Jian Guan,
  • Jian Guan,
  • Jian Guan,
  • Jian Guan,
  • Jian Guan,
  • Yueqi Du,
  • Yueqi Du,
  • Yueqi Du,
  • Yueqi Du,
  • Yueqi Du,
  • Zeyu Fang,
  • Zeyu Fang,
  • Zeyu Fang,
  • Zeyu Fang,
  • Zeyu Fang,
  • Xinyu Wang,
  • Xinyu Wang,
  • Xinyu Wang,
  • Xinyu Wang,
  • Xinyu Wang,
  • Qingyu Yao,
  • Qingyu Yao,
  • Qingyu Yao,
  • Qingyu Yao,
  • Qingyu Yao,
  • Can Zhang,
  • Can Zhang,
  • Can Zhang,
  • Can Zhang,
  • Can Zhang,
  • Shanhang Jia,
  • Shanhang Jia,
  • Shanhang Jia,
  • Shanhang Jia,
  • Shanhang Jia,
  • Zhenlei Liu,
  • Zhenlei Liu,
  • Zhenlei Liu,
  • Zhenlei Liu,
  • Zhenlei Liu,
  • Kai Wang,
  • Kai Wang,
  • Kai Wang,
  • Kai Wang,
  • Kai Wang,
  • Wanru Duan,
  • Wanru Duan,
  • Wanru Duan,
  • Wanru Duan,
  • Wanru Duan,
  • Xingwen Wang,
  • Xingwen Wang,
  • Xingwen Wang,
  • Xingwen Wang,
  • Xingwen Wang,
  • Zuowei Wang,
  • Zuowei Wang,
  • Zuowei Wang,
  • Zuowei Wang,
  • Zuowei Wang,
  • Hao Wu,
  • Hao Wu,
  • Hao Wu,
  • Hao Wu,
  • Hao Wu,
  • Zan Chen,
  • Zan Chen,
  • Zan Chen,
  • Zan Chen,
  • Zan Chen,
  • Fengzeng Jian,
  • Fengzeng Jian,
  • Fengzeng Jian,
  • Fengzeng Jian,
  • Fengzeng Jian

DOI
https://doi.org/10.3389/fneur.2022.900441
Journal volume & issue
Vol. 13

Abstract

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BackgroundNo prior reports have focused on spinal cord injury (SCI) characteristics or inflammation after destruction of the blood–spinal cord barrier by syringomyelia. This study aimed to determine the differences in syringomyelia-related central SCI between craniocervical junction (CCJ) syringomyelia and post-traumatic syringomyelia (PTS) before and after decompression.MethodsIn all, 106 CCJ, 26 CCJ revision and 15 PTS patients (mean history of symptoms, 71.5 ± 94.3, 88.9 ± 85.5, and 32.3 ± 48.9 months) between 2015 and 2019 were included. The symptom course was analyzed with the American Spinal Injury Association ASIA and Klekamp–Samii scoring systems, and neurological changes were analyzed by the Kaplan–Meier statistics. The mean follow-up was 20.7 ± 6.2, 21.7 ± 8.8, and 34.8 ± 19.4 months.ResultsThe interval after injury was longer in the PTS group, but the natural history of syringomyelia was shorter (p = 0.0004 and 0.0173, respectively). The initial symptom was usually paraesthesia (p = 0.258), and the other main symptoms were hypoesthesia (p = 0.006) and abnormal muscle strength (p = 0.004), gait (p < 0.0001), and urination (p < 0.0001). SCI associated with PTS was more severe than that associated with the CCJ (p = 0.003). The cavities in the PTS group were primarily located at the thoracolumbar level, while those in the CCJ group were located at the cervical-thoracic segment at the CCJ. The syrinx/cord ratio of the PTS group was more than 75% (p = 0.009), and the intradural adhesions tended to be more severe (p < 0.0001). However, there were no significant differences in long-term clinical efficacy or peripheral blood inflammation markers (PBIMs) except for the red blood cell (RBC) count (p = 0.042).ConclusionPTS tends to progress faster than CCJ-related syringomyelia. Except for the RBC count, PBIMs showed no value in distinguishing the two forms of syringomyelia. The predictive value of the neutrophil-to-lymphocyte ratio for syringomyelia-related inflammation was negative except in the acute phase.

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