Posttraumatisk syringomyeli

INTRODUCTION: 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.

MATERIAL AND METHODS: During the period 1959-1990 twenty patients with spinal cord injury in East Denmark (including Greenland) developed later symptomatic posttraumatic syringomyelia.

RESULTS: 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.

DISCUSSION: 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.