Incidence, management, and outcome of post-traumatic syringomyelia. In memory of Mr Bernard Williams.

Abstract

To determine the incidence of clinically diagnosable post-traumatic syringomyelia (PTS). A population of 815 consecutive patients with traumatic spinal cord injuries was studied between January 1990 and December 1992. Reviews of all records, full clinical evaluation, and thorough neurological examination of all patients disclosed 28 patients in whom PTS was confirmed radiologically (3.43%). The incidence of the presenting symptoms, including bladder dysfunction, is described. The level and density of cord lesion was correlated with incidence and it was found that posttraumatic syringomyelia was twice as common in patients with complete injuries than in patients with incomplete injuries. The highest incidence was found in patients with complete dorsal and complete dorsolumbar injuries. The interval between injury and diagnosis ranged from six months to 34 years (mean 8.6 years). This interval was shortest in patients with complete dorsal and incomplete cervical and dorsolumbar cord injuries. Reduction of the size of the syrinx seen on postoperative MRI correlated well with a satisfactory clinical outcome in 85% of patients.