gms | German Medical Science

Objective: Spinal cordectomy has been described as an effective treatment option in paraplegic patients for the treatment of syringomyelia to manage spasticity, pain and ascending neurological dysfunction. The objective of this study was to investigate the long-term health-related quality of life (HRQoL) after cordectomy in patients with intractable symptoms caused by syringomyelia.

Methods: Seventeen patients underwent spinal cordectomy for syringomyelia between February 2000 and July 2009. The etiology of syringomyelia was traumatic in 16 patients and spinal ependymoma in one patient. The mean follow-up was 3.8 years (range, 0.9-10.3). The HRQoL was assessed pre- and postoperatively using the EuroQol (EQ; degree of discomfort: 1=none, 2=moderate and 3=extreme) and the short-form SF-36 quality of life score (SF-36). All patients underwent a telephone interview.

Results: The mean pre- and postoperative EuroQol-levels for mobility were 1.8 and 1.5; for self-care, 1.9 and 1.5; for usual activities, 2.1 and 1.5; for pain/discomfort, 2.3 and 2.0; and for anxiety/depression, 1.7 and 1.5, respectively. The mean overall EQ visual analogue scale improved postoperatively from 42 points (range, 15-80) to 67 points (range, 10-95) (p=0.006). The component summary measure for mental health (SF-36) significantly improved postoperatively (p=0.01). A telephone interview revealed a high subjective patient satisfaction (94.1%) in terms of postoperative sequelae. Following the intervention, 58.8% of all patients were employed full or part-time.

Conclusions: Spinal cordectomy may increase the quality of life and can be considered as an ultimo ratio therapy in a selective group of patients with intractable symptoms caused by syringomyelia.