外傷性脊髄空洞症の治療経験

抄録

We report 6 cases of post-traumatic syringomyelia. The mean age at the time of injury was 33.5 years ranging from 18 to 60 years. The paralysis was complete in 5, and incomplete in one case. Their vertebral fractures were treated surgically except for one case. The duration from injury to diagnosis of syringomyelia ranged from 1.25 to 29 years (mean 7.7 years). The intial symptoms were numbness and/or pain, but 2 cases had no symptoms. All cases showed multi-cystic syringomyelia expanding both rostrally and caudally on MR imaging. 4 patients were treated surgically becase of progression of their symptoms. Laminectomy was performed in 3 cases at the thoracic region, and hemi-open laminoplasty in 2 in the cervical region. They underwent syringo-subarachnoid shunting (one required reoperation due to malfunction of the syringo-peritoneal shunting. Postoperative MR imaging showed the disappearence of the syrinx in one case, significant decrease in 2, and very slight decrease in one. The patients obtained improvement of symptoms, but the case who required reoperation showed poor recovery of muscle atrophy.