title: Surgical treatment of scoliosis associated with syringomyelia with no or minor neurologic symptom.
abstract: OBJECTIVE
  Syringomyelia with coexisting intraspinal abnormities is thought to increase the risk of neurologic injury during surgical correction of the scoliosis. However, surgical treatment for intraspinal abnormities carries significant morbidity risks including worsening neurological function and wound complications. The authors' aim in this study was to evaluate one-stage posterior correction of scoliosis in this patient population without prophylactic surgical treatment for neural axis malformations before scoliosis correction.
  
  
  METHODS
  A total of 29 patients with syringomyelia and coexisting intraspinal abnormities who underwent scoliosis correction were evaluated. The average age was 15.6 years (range 12-23). All patients were examined for neural axis abnormalities using MRI, including syringomyelia with Chiari I malformation in 18 patients, syringomyelia with tethered cord and/or diastematomyelia in 11. None of patients presented with symptoms suggesting significant neurological dysfunction. The surgical efficacies and complications of correction were reviewed.
  
  
  RESULTS
  The preoperative Cobb angle of major coronal curve averaged 65° (range 46°-95°), and it measured 28° (range 22°-43°) at the last follow-up, for a 63 % correction. Maximal kyphosis averaged 52° (range 41°-69°) preoperatively, and improved to 29° (range 22°-43°) at ultimate follow-up, for a 46 % correction. The average follow-up was 6 years (4-8 years). None of the patients experienced deterioration in their neurologic status.
  
  
  CONCLUSIONS
  The study results suggested that prophylactic neurosurgery for intraspinal abnormality may be unnecessary in patients with asymptomatic or minor symptomatic syringomyelia and coexisting intraspinal abnormities. One-stage posterior correction of scoliosis in this patient population does not involve significant complications and seems to be an alternative and safe treatment option.
authors.affiliation: Department of Spinal Surgery, Xi'an HongHui Hospital Affiliated to Xi'an JiaoTong University College of Medicine, Xi'an, Shaanxi, China.
authors.forename: Zhen-xing
authors.initials: ZX
authors.lastname: Zhang
authors.forename: Dong-xu
authors.initials: DX
authors.lastname: Feng
authors.forename: Peng
authors.initials: P
authors.lastname: Li
authors.forename: Hai-zhen
authors.initials: HZ
authors.lastname: Zhou
authors.forename: Tuan-jiang
authors.initials: TJ
authors.lastname: Liu
authors.forename: Hua
authors.initials: H
authors.lastname: Hui
authors.forename: Ding-jun
authors.initials: DJ
authors.lastname: Hao
mesh_terms: D000293:Adolescent; D001139:Arnold-Chiari Malformation / Q000150:complications / Q000473:pathology; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009436:Neural Tube Defects / Q000150:complications / Q000473:pathology; D019635:Neurosurgical Procedures; D019637:Orthopedic Procedures; D011859:Radiography; D012189:Retrospective Studies; D012600:Scoliosis / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013595:Syringomyelia / Q000150:complications* / Q000473:pathology; D016896:Treatment Outcome; D055815:Young Adult