Skip to main content

Advertisement

SpringerLink
Log in

Health-related quality of life following spinal cordectomy for syringomyelia

  • Clinical Article
  • Published:
Acta Neurochirurgica Aims and scope Submit manuscript

Abstract

Background

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 satisfactory (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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Brodbelt AR, Stoodley MA (2003) Post-traumatic syringomyelia: a review. J Clin Neurosci 10:401–408

    Article  CAS  PubMed  Google Scholar 

  2. Carroll AM, Brackenridge P (2005) Post-traumatic syringomyelia: a review of the cases presenting in a regional spinal injuries unit in the north east of England over a 5-year period. Spine (Phila Pa 1976) 30:1206–1210

    Google Scholar 

  3. Durward QJ, Rice GP, Ball MJ, Gilbert JJ, Kaufmann JC (1982) Selective spinal cordectomy: clinicopathological correlation. J Neurosurg 56:359–367

    Article  CAS  PubMed  Google Scholar 

  4. Ewelt C, Stalder S, Steiger HJ, Hildebrandt G, Heilbronner R (2010) Impact of cordectomy as a treatment option for posttraumatic and non-posttraumatic syringomyelia with tethered cord syndrome and myelopathy. J Neurosurg Spine 13:193–199

    PubMed  Google Scholar 

  5. Goel A, Desai K (2000) Surgery for syringomyelia: an analysis based on 163 surgical cases. Acta Neurochir (Wien) 142:293–301

    Article  CAS  Google Scholar 

  6. Jansson KA, Nemeth G, Granath F, Jonsson B, Blomqvist P (2005) Health-related quality of life in patients before and after surgery for a herniated lumbar disc. J Bone Joint Surg Br 87:959–964

    Article  PubMed  Google Scholar 

  7. Klekamp JU, Batzdorf U, Samii M, Bothe HW (1997) Treatment of syringomyelia associated with arachnoid scarring caused by arachnoiditis or trauma. J Neurosurg 86:233–240

    Article  CAS  PubMed  Google Scholar 

  8. Laxton AW, Perrin RG (2006) Cordectomy for the treatment of posttraumatic syringomyelia. Report of four cases and review of the literature. J Neurosurg Spine 4:174–178

    Article  PubMed  Google Scholar 

  9. Lee TT, Alameda GJ, Camilo E, Green BA (2001) Surgical treatment of post-traumatic myelopathy associated with syringomyelia. Spine (Phila Pa 1976) 26:S119–S127

    CAS  Google Scholar 

  10. Roser F, Tatagiba MS (2007) Posttraumatic syringomyelia. J Neurosurg Spine 6:193–194

    Article  PubMed  Google Scholar 

  11. Sgouros S, Williams B (1996) Management and outcome of posttraumatic syringomyelia. J Neurosurg 85:197–205

    Article  CAS  PubMed  Google Scholar 

  12. Ushewokunze SO, Gan YC, Phillips K, Thacker K, Flint G (2010) Surgical treatment of post-traumatic syringomyelia. Spinal Cord 48:710–713

    Article  CAS  PubMed  Google Scholar 

  13. Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483

    Article  PubMed  Google Scholar 

  14. (1990) EuroQol—a new facility for the measurement of health-related quality of life. The EuroQol Group. Health Policy 16:199–208

Download references

Acknowledgments

We would like to thank all individuals who played a role in this study; in particular, we would like to thank all patients, Annelies Konrad and the staff from the Swiss Paraplegic Center in Nottwil. We also thank Ms. Leona von Schnakenburg for her editorial support.

Conflicts of interest

None.

Funding

There was no funding for this study.

Author contribution

Both authors Oliver P. Gautschi and Martin A. Seule have equally contributed to the manuscript and should therefore both be regarded as first authors.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, State Hospital, St. Gallen, Switzerland

    Oliver Pascal Gautschi, Martin Alexander Seule, Michael Gores, Gerhard Hildebrandt & Raoul Heilbronner

  2. Division of Trauma Surgery, University Hospital Zurich, Zurich, Switzerland

    Dieter Cadosch

  3. Department of Neurosurgery, University Hospital, Münster, Germany

    Christian Ewelt

  4. Klinik für Neurochirurgie, Kantonsspital St. Gallen, Rorschacher Strasse 95, CH-9007, St. Gallen, Switzerland

    Oliver Pascal Gautschi

Authors
  1. Oliver Pascal Gautschi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Martin Alexander Seule
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dieter Cadosch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Michael Gores
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christian Ewelt
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gerhard Hildebrandt
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Raoul Heilbronner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Oliver Pascal Gautschi.

Additional information

Comment

Very well-done paper describing the improvement in quality of life associated with a last-ditch effort to treat progressive neurological deterioration in patients with syringomyelia. The authors are congratulated on compiling health-related quality-of-life data in this patient population. The data provided give neurosurgeons confidence in managing these very difficult patients with what is largely considered a drastic procedure.

Daniel Resnick

Wisconsin, USA

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gautschi, O.P., Seule, M.A., Cadosch, D. et al. Health-related quality of life following spinal cordectomy for syringomyelia. Acta Neurochir 153, 575–579 (2011). https://doi.org/10.1007/s00701-010-0869-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00701-010-0869-1

Keywords

Search

Navigation