title: Pain improvement in patients with syringomyelia and Chiari I malformation treated with suboccipital decompression and tonsillar coagulation.
abstract: Pain experienced by patients who have syringomyelia associated with Chiari I malformation (SACM) includes headache, cervicalgia and radiculalgia. We studied the correlation of clinical and imaging factors with the evolution of pain and surgical outcome at 12 months. We performed a prospective study of 13 patients who presented with SACM and who underwent suboccipital decompression, C1 laminectomy, tonsillar coagulation and duraplasty. The Bidzinski Outcome Scale was used. Post-operatively, pain improvement was observed in 11 patients and the syrinx resolved in 6 patients and reduced in 7. Eleven patients had a good or very good outcome, while 2 patients had a poor outcome. A post-operative medullary axial occupation of the syrinx less than 75% of the spinal canal was associated with improved post-operative pain. Longer duration of symptomatology was associated with a poor outcome and failed pain control. The size and form of the syrinx, as well as early surgical treatment, are the factors that most influence the control of pain post-surgery in patients with SACM.
authors.affiliation: Department of Neurosurgery, Hospital La Fe Valencia, Avenida de Campanar 21, Valencia 46009, Spain. ricprat@ono.com
authors.forename: R
authors.initials: R
authors.lastname: Prat
authors.forename: I
authors.initials: I
authors.lastname: Galeano
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001139:Arnold-Chiari Malformation / Q000150:complications*; D016009:Chi-Square Distribution; D019299:Decompression, Surgical / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology* / Q000601:surgery*; D012720:Severity of Illness Index; D013595:Syringomyelia / Q000150:complications*; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult