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Case Reports
. 2018 Apr-Jun;8(2):76-90.

THE PROFILE AND SURGICAL TREATMENT OF SYRINGOMYELIA IN NIGERIAN PATIENTS

Aek Ukachukwu  1 , M T Shokunbi  2   1 , L O Tiamiyu  1 , A A Adeolu  2   1 , A O Malomo  2   1
Affiliations
Case Reports

THE PROFILE AND SURGICAL TREATMENT OF SYRINGOMYELIA IN NIGERIAN PATIENTS

Aek Ukachukwu et al. J West Afr Coll Surg. 2018 Apr-Jun.

Abstract

Background: Syringomyelia is an often progressive disorder of the spinal cord. There is a dearth of reports in the African population.

Aims and objectives: This study describes the profile and the outcome of treatment in our population of patients.

Design of the study: A retrospective review of patients surgically treated for syringomyelia over a ten year period.

Setting: Department of Neurological Surgery, University College Hospital, Ibadan, Nigeria.

Materials and methods: Eight patients were surgically treated for Syringomyelia over the period 2004-2014. We extracted data on their gender, age, aetiology, syrinx location, diagnosis, operative procedure and outcome. Simple statistical analysis was done.

Results: There were five males and three females. The mean age was 31.6(SD15.3) years (median: 32.5 years). The causes of the syrinx were: Chiari malformation (3), intramedullary spinal tumour (2), foramen magnum tumour (1), post-traumatic (1), and iatrogenic chemical arachnoiditis (1). The syrinx location was: cervical region (4), cervicothoracic region (2) and multi-level (2). The operative procedures were posterior fossa decompression (2), sub-occipital craniectomy with laminectomy and tumour excision (2), laminectomy and syringomyelotomy (2), laminectomy and tumour excision (1), and ventriculoperitoneal shunting (1). The duration of follow up was 2 weeks to 35 months. Outcome was satisfactory in six patients. A child who had initial ventriculoperitoneal shunting died at home before definitive surgery, and an adult male died of respiratory insufficiency post operatively.

Conclusion: Syringomyelia is rare in our population. It affects young patients, typically in the cervico-thoracic region. The aetiologies are similar to those from previous reports. The outcome of surgical treatment in our small group of patients is satisfactory.

Keywords: Nigerians; Syringomyelia; Treatment.

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Figures

FIGURE 1
FIGURE 1. A, B and C show pre-operative sagittal T1W and sagittal and axial T2W MR images of patient YS, 36-year old male, with post-traumatic cervical syringomyelia and C4 myelopathy. D, E and F show immediate post-operative sagittal T1W and T2W MR images of patient YS showing some resolution of the syrinx following C5-6 laminectomies and syringomyelotomy
FIGURE 2
FIGURE 2. A, B and C show pre-operative sagittal T1W and sagittal and axial T2W MR images of patient SH, 24-year old female, with Chiari malformation and cervico-thoracic syringomyelia. D, E F show 15-week post-operative sagittal T1W and sagittal and axial T2W MR images of patient SH showing significant resolution of the syrinx following sub-occipital craniectomy, excision of C1 posterior ring and augmented duroplasty
See this image and copyright information in PMC

References

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    1. Tubbs RS, Hankinson TC, Wellons JC. The Chiari malformations and syringohydromyelia. In: Ellenbogen RG, Abdulrauf SI, Sekhar LN, editors. Principles of Neurological Surgery. 3rd ed Elsevier Saunders; Philadelphia USA: 2012. pp. 164–168.
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    1. Rusbridge C, Greitz D, Iskandar BJ. Syringomyelia: current concepts in pathogenesis, diagnosis and treatment. . Vet Intern Med. 2006;20:469–479. - PubMed
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