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Chiari I malformation associated with syringomyelia: can foramen magnum decompression lead to restore cervical alignment?

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Abstract

Purpose

There are few researches that demonstrate the relationship between the extent of syringomyelia and sagittal alignment of the cervical spine. The purpose of this study is to investigate the correlation between the change of syrinx size and cervical alignment.

Methods

From January 2001 to June 2008, we operated on 207 patients who had syringomyelia. The associated diseases were categorized by Chiari I malformation, tumor, trauma, spinal stenotic lesion, inflammatory disease and idiopathic causes. Thirty patients who had Chiari I malformation associated with syringomyelia and who underwent foramen magnum decompression (FMD), participated in this study. We excluded patients with scoliosis, cervical instrumentation, tumor, trauma, myelomeningocele, hydrocephalus, tethered cord and congenital vertebral anomalies. Lateral radiographs in neutral and magnetic resonance imaging were taken pre- and postoperatively.

Results

Mean follow-up was 6.5 ± 1.5 years (ranged from 4.0 to 9.5 years). The mean pre- and postoperative lordosis angles at C2–C7 were −5.9° ± 1.0° and −10.4° ± 1.0°, respectively (P = 0.001). There was significant correlation between the differences of syrinx width and the cervical lordotic angles before and after surgery (P = 0.016). After FMD, syringomyelia and cervical alignment improved in 28 (93.3 %) and 25 (85.18 %) of 30 patients, respectively. There was significant correlation between recovery rate by Japanese Orthopaedic Association scores and the difference of the cervical lordotic angles before and after surgery (P = 0.022).

Conclusions

The present results demonstrate that the decrease of syrinx size by FMD may restore the cervical lordosis. We suggest that the postoperative cervical alignment might be a predictive factor for neurological outcome.

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Abbreviations

FMD:

Foramen magnum decompression

MRI:

Magnetic resonance imaging

JOA:

Japanese Orthopaedic Association

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Acknowledgments

The manuscript submitted does not contain information about medical device(s)/drug(s). No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Conflict of interest

None of the authors has any conflict of interest in the subject under discussion in this paper.

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Authors and Affiliations

  1. Department of Neurosurgery, Spine Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam, Gyeonggi, 463-707, South Korea

    Seung Jae Hyun, Ji Woong Kwon, Chang Hyun Lee, Ki-Jeong Kim, Tae Ahn Jahng & Hyun Jib Kim

  2. Spine Center, Department of Neurosurgery, Ansan 21st Century Hospital, Ansan, South Korea

    Kyung Yun Moon

  3. Department of Neurosurgery, Kangwon National University Hospital, Kangwon National University College of Medicine, Chuncheon, Korea

    Jiha Kim

  4. Department of Neurosurgery, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yeongeon-dong, Jongno-gu, Seoul, 110-744, South Korea

    Chun Kee Chung

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  1. Seung Jae Hyun
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  2. Kyung Yun Moon
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  4. Chang Hyun Lee
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  5. Jiha Kim
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  7. Tae Ahn Jahng
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  9. Hyun Jib Kim
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Corresponding author

Correspondence to Tae Ahn Jahng.

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Hyun, S.J., Moon, K.Y., Kwon, J.W. et al. Chiari I malformation associated with syringomyelia: can foramen magnum decompression lead to restore cervical alignment?. Eur Spine J 22, 2520–2525 (2013). https://doi.org/10.1007/s00586-013-2876-4

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  • DOI: https://doi.org/10.1007/s00586-013-2876-4

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