Surgical management of syringomyelia associated with spinal arachnoid cyst: Clinical and radiological outcomes
Mykola Gorbachuk (Tübingen), Eliane Weinbrenner (Tübingen), Marcos Tatagiba (Tübingen), Sasan Darius Adib (Tübingen)
Syringomyelia associated with spinal arachnoid cyst (SAC) is a rare disease entity. This study aimed to analyze the surgical management of SAC in patients with syringomyelia, focusing on clinical and radiological outcomes.
A total of 135 patients with syringomyelia (not included were patients with neoplastic lesions associated with syringomyelia) underwent surgery at our department between November 2003 and December 2022. All patients underwent magnetic resonance imaging (MRI), with a special syringomyelia protocol (including TrueFISP and CINE), and electrophysiology. Among these patients, we searched for patients with SAC with syringomyelia following careful analysis of patient documents (including neuroradiological and neuropathological data, surgical reports and follow-up data). Patients were evaluated for initial symptoms, surgical strategies, and complications, furthermore clinical and radiological outcomes.
In 17 patients (12,59%) of the 135 patients, the syringomyelia was associated with a SAC. The mean patient age was 51± 12.37 years. 12 patients were male, and 5 were female. The extension of syringomyelia involved in one case only the cervical, in nine cases the cervicothoracic, in four cases only the thoracic, in two cases the thoracolumbar and in one case the cervicothoracolumbar spinal cord. Complete removal of SAC was achieved in 16 cases, fenestration of the SAC was performed in one case. Postoperatively, one patient needed revision surgery due to spinal epidural bleeding in the level of the SAC. In first follow-up (mean duration was 3,7 months) the size of syringomyelia decreased in 16 cases (in two cases the syringomyelia was even not detectable anymore), in one case the size of syringomyelia was unchanged. Clinical symptoms improved in 15 cases and were unchanged in two cases.
In summary SACs can be safely treated by surgery. Clinical symptoms and syringomyelia improves in most cases after surgery.
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