The natural history and the influence of surgical treatment in syringomyelia.

A retrospective analysis was made of the natural history and treatment of 44 patients with syringomyelia, followed for a median interval of 10 years after diagnosis. Twenty-four patients were treated surgically. Four of 12 patients who had a laminectomy with aspiration of the syrinx or syringostomy, and 7 of 15 patients who underwent decompression and exploration of the cervicomedullary junction, showed sustained improvement or stabilisation of their neurological deficits. When symptoms had been present for more than 2 years, when there was a moderate or severe neurological disability, and when the patient was more than 40 years old, the long-term outlook of posterior fossa surgery was usually poor. Of the 20 patients who did not have an operation, 7 had no further progression in symptoms after presentation and prolonged survival was usual. It is concluded that in many cases syringomyelia is compatible with prolonged survival, and although improvement can follow surgery, its influence on the disease in the long-term is uncertain.