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. 2023 Jun;123(3):807-814.
doi: 10.1007/s13760-023-02264-4. Epub 2023 Apr 12.

A novel scoring system for assessing adult syringomyelia associated with CM I treatment outcomes

Jian Guan #  1   2   3   4 , Chenghua Yuan #  1   2   3   4 , Qingyu Yao  1   2   3   4 , Yueqi Du  1   2   3   4 , Zeyu Fang  1   2   3   4 , Lei Zhang  1   2   3   4 , Shanhang Jia  1   2   3   4 , Can Zhang  1   2   3   4 , Zhenlei Liu  1   2   3   4 , Kai Wang  1   2   3   4 , Wanru Duan  1   2   3   4 , Zuowei Wang  1   2   3   4 , Xingwen Wang  1   2   3   4 , Hao Wu  1   2   3   4 , Zan Chen  1   2   3   4 , Fengzeng Jian  5   6   7   8
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A novel scoring system for assessing adult syringomyelia associated with CM I treatment outcomes

Jian Guan et al. Acta Neurol Belg. 2023 Jun.

Abstract

Background: A specific scoring system for syringomyelia is lacking. Our objective was to investigate the value of a novel scoring system (Syringomyelia Outcome Scale of Xuanwu hospital, SOS-XW) in assessing surgical outcomes in the treatment of syringomyelia (SM) associated with Chiari malformation type I (CM I).

Methods: A quantitative evaluation system (SOS-XW) of SM includes 4 parameters: pain (P), sensation (S), movement (M), and syringomyelia tension index (STI). The clinical data of 88 patients with CM I-related syringomyelia treated by foramen magnum and Magendie dredging (FMMD) from January 2018 to January 2019 were retrospectively analysed with a mean follow-up of 14.3 months, and the SOS-XW score was used to assess the efficacy.

Results: The higher the SOS-XW score, the more severe was the SM and related symptoms. The mean preoperative score was 5.97, and the postoperative score was 2.66. The symptom improvement rates were 77.78% for P, 69.01% for S, 31.82% for M, and 95.06% for the syringomyelia tension index (STI). The symptom improvement rate of the PSM score was weakly correlated with the improvement rate of STI, R2 = 0.0016. The percentage of PSM (P + S + M) improvement was lower in patients with an STI of 0. The postoperative SOS-XW score was positively correlated with the postoperative JOA score, R2 = 0.8314. The positive detection rate of SOS-XW was higher than that of the JOA score.

Conclusions: To evaluate the surgical procedure efficacy in the treatment of syringomyelia, the SOS-XW score can provide a more objective, detailed, and comprehensive analysis, especially STI. A reduction in STI is the practical standard for assessing the effectiveness of surgery.

Keywords: Chiari malformation type I; Natural history; Scoring system; Syringomyelia.

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