Nielsen Ole Amtoft, Biering-Sørensen Fin, Mosdal Claus
Neurokirurgisk Afdeling H, Amtssygehuset i Glostrup, DK-2600 Glostrup.
Ugeskr Laeger. 2003 Jul 14;165(29):2879-82.
A longitudinal cavity in the medulla spinalis is known as a syringomyelia. If the cavity is a widening of the central canal, it is known as hydromyelia. Traumatic spinal cord injury may lead to the development of syringomyelia.
During the period 1959-1990 twenty patients with spinal cord injury in East Denmark (including Greenland) developed later symptomatic posttraumatic syringomyelia.
The mean time from trauma to diagnosis was 12 years. Mean time from first symptom to time of diagnosis was three years. Thirteen patients were operated with syringoperitoneal drain, myelotomy or decompression of the spinal cord and dural reconstruction. The best effect of the operations was on pain; little or no effect was found on activities of daily living, motor function, spasticity, sensibility, and bladder and bowel function.
The main objective of performing operation is to stop further development of disabling symptoms. We recommend that patients with spinal cord injury have an MRI performed three months after injury independent of recovery. If a cyst or syrinx is present or relevant clinical symptoms emerge, MRI should be performed every three months. If no cyst or syrinx or changes in neurological status develop, MRI should be performed every six months. If no changes are seen in two years, MRI should be performed every two or more years.
脊髓内的纵向空洞称为脊髓空洞症。如果空洞是中央管的扩张，则称为积水性脊髓空洞症。创伤性脊髓损伤可能导致脊髓空洞症的发生。
在1959年至1990年期间，丹麦东部（包括格陵兰岛）有20例脊髓损伤患者后来出现了有症状的创伤后脊髓空洞症。
从创伤到诊断的平均时间为12年。从首次出现症状到诊断的平均时间为3年。13例患者接受了脊髓空洞-腹腔分流术、脊髓切开术或脊髓减压及硬脊膜重建手术。手术的最佳效果体现在疼痛方面；对日常生活活动、运动功能、痉挛、感觉以及膀胱和肠道功能几乎没有影响。
进行手术的主要目的是阻止致残症状的进一步发展。我们建议脊髓损伤患者在受伤后3个月进行MRI检查，无论恢复情况如何。如果存在囊肿或空洞或出现相关临床症状，应每3个月进行一次MRI检查。如果没有囊肿、空洞或神经状态变化，应每6个月进行一次MRI检查。如果两年内未见变化，应每两年或更长时间进行一次MRI检查。
