title: Surgical outcomes in adult patients with syringomyelia associated with Chiari malformation type I: the relationship between scoliosis and neurological findings.
abstract: OBJECTIVE
  The clinical characteristics of pediatric scoliosis associated with syringomyelia have been reported in previous studies, but scoliosis associated with syringomyelia in adults is rarely treated, and there is a paucity of detailed studies. In the present study of adult syringomyelia associated with Chiari malformation Type I, the authors investigated the relationships among the syrinx, scoliosis, and neurological data.
  
  
  METHODS
  The population was composed of 27 patients (> or = 20 years of age) who underwent foramen magnum decompression for the treatment of syringomyelia. The patients were divided into two groups: those with scoliosis of 10 degrees or more (Group A) and those without scoliosis (Group B). The authors assessed the length of the syrinx, duration of morbidity, and clinical status before and after surgery based on the Japanese Orthopaedic Association (JOA) Scale. There were 15 cases in Group A and 12 in Group B. The mean length of the syrinx was 12.8 vertebral bodies (VBs) in Group A and 7.2 VBs in Group B. The mean duration of morbidity was 14.2 years in Group A and 6.8 years in Group B. The mean preoperative JOA score was 10.1 in Group A and 14.4 in Group B, whereas the mean postoperative JOA scores were 11.9 and 15.8, respectively. There were significant differences between Groups A and B in length of the syrinx, duration of morbidity, and pre- and postoperative JOA scores.
  
  
  CONCLUSIONS
  In patients with syringomyelia and scoliosis the syringes spanned a greater number of VBs, the duration of morbidity was greater, neurological dysfunction was more severe, and surgical results were poorer. Scoliosis could be a predicting factor of the prognosis in patients with syringomyelia and Chiari malformation Type I.
authors.affiliation: Department of Orthopaedic Surgery, Hirosaki University School of Medicine, Japan. atsu-ono@cc.hirosaki-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ono
authors.forename: Futoshi
authors.initials: F
authors.lastname: Suetsuna
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Ueyama
authors.forename: Toru
authors.initials: T
authors.lastname: Yokoyama
authors.forename: Shuichi
authors.initials: S
authors.lastname: Aburakawa
authors.forename: Takuya
authors.initials: T
authors.lastname: Numasawa
authors.forename: Kanichiro
authors.initials: K
authors.lastname: Wada
authors.forename: Satoshi
authors.initials: S
authors.lastname: Toh
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001139:Arnold-Chiari Malformation / Q000150:complications* / Q000473:pathology; D019299:Decompression, Surgical; D005260:Female; D005539:Foramen Magnum / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D012600:Scoliosis / Q000209:etiology / Q000601:surgery*; D018709:Statistics, Nonparametric; D013595:Syringomyelia / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome