Maharaj Monish M, Phan Kevin, Mobbs Ralph
NeuroSpine Surgery Research Group (NSURG), Sydney, Australia; Faculty of Medicine, University of New South Wales, Sydney, Australia.
NeuroSpine Surgery Research Group (NSURG), Sydney, Australia; Faculty of Medicine, University of Sydney, Sydney, Australia.
J Clin Neurosci. 2017 Oct;44:249-253. doi: 10.1016/j.jocn.2017.06.065. Epub 2017 Jul 14.
Syringomyelia defines a condition in which myelopathy develops secondary to the formation of a cyst or cavity within the spinal cord parenchyma known as a syrinx. Although there is a significant volume of studies analysing the underlying mechanisms behind their formation, the management of such cavities remains an ongoing topic of debate. Aside from conservative approach, a range of surgical options exist, however long term outcomes are poor and a literature search reveals that the overall benefits are questionable. We present a 31-year-old man with an incidental finding of a syrinx on MRI following a traumatic spinal cord injury. Following a decompression and 360° fusion at the C6/7 level for a fracture-dislocation, the patient developed a delayed syrinx (54mm×11mm×8mm), and was managed conservatively. Over 2-year follow-up, the volume of the syrinx spontaneously reduced (46×5×5). Conservative treatment including careful observation is advisable as the first line therapy in patients with a post-traumatic syrinx. Surgery may be indicated in patients with progressive neurological symptoms, however there is a distinct lack of robust evidence on the long-term efficacy of surgery.
脊髓空洞症是指脊髓实质内形成一个称为空洞的囊肿或腔隙后继发脊髓病的一种病症。尽管有大量研究分析其形成背后的潜在机制，但对这类腔隙的治疗仍是一个持续争论的话题。除了保守治疗方法外，还存在一系列手术选择，然而长期效果不佳，文献检索表明总体益处存疑。我们报告一名31岁男性，在脊髓损伤后行MRI检查时偶然发现脊髓空洞。在C6/7水平因骨折脱位行减压和360°融合术后，患者出现延迟性脊髓空洞（54mm×11mm×8mm），并接受了保守治疗。经过2年随访，脊髓空洞体积自发缩小（46×5×5）。对于创伤后脊髓空洞症患者，保守治疗包括仔细观察，作为一线治疗是可取的。对于有进行性神经症状的患者可能需要手术治疗，然而关于手术长期疗效的有力证据明显不足。
