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KMID : 1145220220190041057
Neurospine
2022 Volume.19 No. 4 p.1057 ~ p.1070
Relationship Between Syrinx Resolution and Cervical Sagittal Realignment Following Decompression Surgery for Chiari I Malformation Related Syringomyelia Based on Configuration Phenotypes
Lu Chunli

Ma Longbing
Guan Jian
Liu Zhenlei
Wang Kai
Duan Wanru
Chen Zan
Wu Hao
Jian Fengzeng
Abstract
Objective: Combined with different configuration types of syringomyelia, to analyze the correlation between syrinx resolution and changes in cervical sagittal alignment following Foramen magnum and Magendie dredging (FMMD) for syringomyelia associated with Chiari I malformation (CM-I), and to further explore the respective relationship with clinical outcome.

Methods: A consecutive series of 127 patients with CM-I and syringomyelia who underwent FMMD in our center met the inclusion criteria of this study. Their clinical records and radiologic data were retrospectively reviewed. The Japanese Orthopedic Association (JOA) scoring system and the Chicago Chiari Outcome Scale (CCOS) were used to evaluate the surgical efficacy. The phenotypes of syringomyelia and the clinical characteristics of the patients were analyzed according to grouping by cervical curvature at baseline.

Results: The preoperative straight or kyphotic cervical alignment is more common in the moniliform syrinx. After surgery, the syrinx resolution and cervical sagittal realignment in the moniliform group are more obvious, and the corresponding prognosis is relatively better. Spearman correlation analysis showed that the ¥ÄS/C ratio (the change ratio of syrinx/cord) was positively correlated with the CCOS (p = 0.001, r = 0.897) and ¥ÄC2?7A (the change of lower cervical angle) (p = 0.002, r = 0.560). There was also a correlation between the ¥ÄJOA score (the change rate of the JOA score) and ¥ÄC2?7A (p = 0.012, r = 0.467).

Conclusion: After decompression surgery, syrinx resolution may coexist with the changes in the subaxial lordosis angle, especially for syrinx in moniliform type, and the relationship between syrinx resolution and cervical sagittal realignment might be valuable for evaluating the surgical outcome.
KEYWORD
Cervical sagittal alignment, Syringomyelia, Chiari malformation, Decompression surgery, Prognosis
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