gms | German Medical Science

Objective: Syringomyelia, the formation and expansion of a cyst or syrinx within the spinal cord, is a centromedullary syndrome accompanied by pain, numbness, and dissociative symptoms. The majority of patients undergo a steady progression and escalation of neurological symptoms. Although various forms of conservative and neurosurgical treatments exist, it remains unclear how neurosurgical intervention affects quality of life and what syringomyelia patient subgroups profit by such an intervention.

Methods: Physical and mental quality of life was assessed in 142 patients with syringomyelia via the standardized SF-36 questionnaire (physical and mental component scores [PCS/MCS]), a Syringomyelia-Disability-Index (SDI) to determine functional disability, and an individualized questionnaire to summarize clinical history.

Results: Underlying syringomyelia pathologys varied, including prevalent Chiari-Malformations, as well as spinal trauma, spinal tumors, and others. Syringomyelia patient SF-36 component scores (PCS/MCS) were significant lower compared to the general German population as well as patients suffering from other chronic diseases. Scores from surgically treated patients did not differ significantly from those treated conservatively, nor were scores dependent upon underlying syrinx pathology. Cluster analysis revealed four patient groups based on quality of life patterns, displaying characteristics of clinical presentation and history.

Conclusions: Syringomyelia is a chronic and progressive disorder. As confirmed by cluster analysis, clinical deterioration can be avoided and a high quality of life can be maintained provided that experts employing appropriate diagnostic tools intervene promptly. As the syrinx itself appears to be the source of symptoms, it is necessary to treat the pathology that preserves the syrinx cavity.