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  • Title: Surgical outcomes of foramen magnum decompression for syringomyelia associated with Chiari I malformation: relation between the location of the syrinx and body pain.
    Author: Ono A, Numasawa T, Wada K, Yokoyama T, Takeuchi K, Suetsuna F, Ueyama K, Toh S.
    Journal: J Orthop Sci; 2010 May; 15(3):299-304. PubMed ID: 20559796.
    Abstract:
    BACKGROUND: There have been few reports about the relation between the morphology of syrinxes and body pain in syringomyelia associated with Chiari I malformation. To investigate this phenomenon, the relation between the location of the syrinx and body pain before and after foramen magnum decompression (FMD) were evaluated. METHODS: The subjects were 20 patients with Chiari I malformation associated with syringomyelia who underwent FMD. The morphology of the syrinxes was classified into three types - enlarged type, which was a distended syrinx at the central spinal cord; deviated type, which was a deviated syrinx posterolaterally within the spinal cord; central type, which was a small syrinx at the central canal of the spinal cord - based on axial magnetic resonance imaging (MRI). Preoperative and postoperative clinical symptoms and the body pain were evaluated by the Japanese Orthopaedic Association (JOA) score and a visual analogue scale (VAS) prospectively. RESULTS: Preoperative and postoperative JOA scores showed no statistically significant differences between the three syrinx types. Intensity of body pain evaluated by the VAS showed that patients with a deviated-type syrinx on pre- and postoperative MRI tended to be associated with more intense pain than the other two types. CONCLUSIONS: It was indicated that pain before and after surgery is more intense when the syrinx is deviated toward the spinal dorsal horn as seen on MRI.
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