gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

Syringomyelia – the eminent role of quality of life in its treatment

Aspekte der Lebensqualität bei Syringomyelie

Meeting Abstract

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  • corresponding author C. Sixt - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • F. Riether - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • M. Tatagiba - Klinik für Neurochirurgie, Universitätsklinikum Tübingen
  • F. Roser - Klinik für Neurochirurgie, Universitätsklinikum Tübingen

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSO.05.04

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dgnc2007/07dgnc241.shtml

Published: April 11, 2007

© 2007 Sixt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Syringomyelia describes a centromedullary syndrome, associated with dissociative symptoms. Quality of life should play the overriding role in the choice of treatment. It is still unclear how neurosurgical interventions affect the quality of life in patients with syringomyelia and what subgroups do profit from an operation.

Methods: Life quality in patients with syringomyelia was assessed through standardized questionnaires SF-36, a Syringomyelia Disability Index (SDI) and an clinical history index. PCS and MCS of SF-36 questionnaire are cumulative values, the SDI includes 23 questions concerning routine activities, pain and physical function correlates highly with the PCS Score. 106 patients with Syringomyelia could be analysed with a complete set of data. The underlying pathology was an Arnold-Chiari-Malformation (ACM, 27,4%), spinal trauma – including major (spinal cord injury) and minor (no neurological deficits) traumas (22,6%), intramedullary tumours including arachnoid cysts (13,2%), a history of meningitis (5,6%) and scoliosis (1,9%).

Results: Patients consulted the physicians for various symptoms like pain, numbness, gait ataxia, paresis, vertigo, headache as well as bladder- and swallowing disturbance. Patients diagnosed for more than ten years with syringomyelia have significantly worse scores than patients diagnosed during the last five years (P-value 0.0051). Related to the normal healthy population, the PCS in syringomyelia is lower than in any other chronic disease including heart failure and diabetes. No significant difference in the PCS-Score and in the SDI was seen among the scores of patients, who underwent neurosurgical therapy (PCS 32.2; SDI 61.2) and those who were treated conservatively (PCS 37.8; SDI 66.13).

Conclusions: The methodical evaluation of syringomyelia demonstrates a highly inhomogeneous appearance of a disease, most often treated symptomatically. The severity of symptoms and variations in symptomatology are not correlated to the underlying pathology. Over time and with long follow-up studies, syringomyelia shows a chronic progressive nature with neurological deterioration. Allegedly the subjective impression of the physical and mental status is comparable to other severe chronic diseases. As syringomyelia affects only an imperceptible number of patients, its recognition and acceptance is still underrated.