Department of Neurosurgery, APEX Medical Center, Şişli, Istanbul, Turkey.
Department of Neurosurgery, Bahçelievler State Hospital, Bahçelievler, Istanbul, Turkey.
Ideggyogy Sz. 2024 Jul 30;77(7-8):273-280. doi: 10.18071/isz.77.0273.
Syringomyelia is a neurological condition in which a longitudinal fluid-filled cavity is formed within the spinal cord. It usually occurs in the cervical region and is associated with Chiari malformation, infections, trauma, and tumors of the spinal cord. However, syringomyelia associated with cervical disc disease (SCD) is very rare and only a few cases have been reported so far. This case report presents the clinical and radiological findings of 13 cases of SCD to describe the properties of SCD and explore the nature of the relationship between syringomyelia and cervical disc disease.
.SCD was diagnosed in 13 using MRI findings, including coexistence of syringomyelia and cervical disc disease, presence of narrowed cervical subarachnoid space secondary to the cervical disc herniation or cervical local kyphosis associated with cervical disc degeneration or herniation, and the cervical disc herniation or segmental kyphosis and syrinx should be located within the same levels. The MRI findings were used to grade the syrinx and determine whether the cervical disc herniation or local kyphosis was located at the proximal or distal end of the syrinx.
.All patients had single-level disc herniation or kyphosis, the most common level being C5–6 (n = 6), followed by C6–7 (n = 4) and C4–5 (n = 3). Eight patients had a distal type (disc disease located in the proximal end of the syrinx) SCD while five had the proximal variety (cervical disc disease located in the distal end of the syrinx). The average length of the syrinx was two vertebral segments. Surgery was performed in five cases and some degree of syrinx resolution was observed in all of them.
Discussion – The main cause of syringomyelia is obstruction of cerebrospinal fluid (CSF) pathways; total obstruction could cause distal syrinx, whereas partial obstruction could cause proximal or distal syrinxes. Restoration of CSF pathways may result in some degree of resolution of syringomyelia. A causal association may exist between cervical disc disease and cervical syringomyelia but needs further exploration.
SCD is a mild form of syringomyelia with symptoms primarily arising due to disc herniation or local kyphosis. The surgical treatment of the cervical disc disease is sufficient and results in a syringomyelia resolution of some degree.
.脊髓空洞症是一种神经系统疾病，其中脊髓内形成一个纵向的充满液体的腔。它通常发生在颈部区域，与 Chiari 畸形、感染、创伤和脊髓肿瘤有关。然而，与颈椎间盘疾病相关的脊髓空洞症（SCD）非常罕见，迄今为止仅报道了少数病例。本病例报告介绍了 13 例 SCD 的临床和影像学发现，以描述 SCD 的特征，并探讨脊髓空洞症与颈椎间盘疾病之间的关系性质。
。通过 MRI 发现诊断为 13 例 SCD，包括脊髓空洞症和颈椎间盘疾病共存，颈椎间盘突出或颈椎局部后凸导致颈段蛛网膜下腔变窄，与颈椎间盘退变或突出有关，颈椎间盘突出或节段后凸和脊髓空洞症应位于同一水平。使用 MRI 发现对脊髓空洞症进行分级，并确定颈椎间盘突出或局部后凸位于脊髓空洞症的近端还是远端。
。所有患者均有单节段椎间盘突出或后凸，最常见的节段为 C5-6（n = 6），其次为 C6-7（n = 4）和 C4-5（n = 3）。8 例为远端型（椎间盘疾病位于脊髓空洞症的近端）SCD，5 例为近端型（颈椎间盘疾病位于脊髓空洞症的远端）。脊髓空洞症的平均长度为两个椎体节段。5 例患者接受了手术治疗，所有患者的脊髓空洞症均有一定程度的缓解。
讨论-脊髓空洞症的主要原因是脑脊液（CSF）通路阻塞；完全阻塞可导致远端脊髓空洞症，而部分阻塞可导致近端或远端脊髓空洞症。恢复 CSF 通路可能会导致脊髓空洞症的一定程度的缓解。颈椎间盘疾病与颈椎脊髓空洞症之间可能存在因果关系，但需要进一步探讨。
SCD 是一种轻度的脊髓空洞症，主要症状是由于椎间盘突出或局部后凸引起的。颈椎间盘疾病的手术治疗是充分的，并导致一定程度的脊髓空洞症缓解。
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