242. Relationship Between Location of Scoliosis and Syrinx in Idiopathic Syringomyelia

Authors: Jeffrey Nadel, MD; Catherine Ziats, MD; James Mossner, MS; Jordan Starr, BS; Brandon Smith, MD, MS; Karin Muraszko, MD; Hugh Garton, MD, MHSc; Cormac Maher, MD; Jennifer Strahle, MD (Salt Lake City, UT)

Introduction:

Many individuals with idiopathic syrinx also have scoliosis. We describe the relationship between curve apex & syrinx location & change over time.   

Methods:

Patients with idiopathic syrinx (> 3mm) were identified from a database of consecutive patients undergoing magnetic resonance imaging of the brain or cervical spine over 11-years.  Patients with any syrinx-associated pathology were excluded. In those with scoliosis and idiopathic syrinx, curve characteristics & changes in syrinx over time were recorded.

Results:

Twenty-seven patients had both clinical & radiographic follow up for idiopathic syrinx & scoliosis. Average clinical follow-up was 7.4 + 4.3 years & average radiographic follow-up was 5.6 + 3.8 years. Forty-four percent were women. Average age at syrinx diagnosis was 9.8 + 4.4 years & 9.3 + 4.3 years at scoliosis diagnosis. At presentation, 85% of patients most of their syrinx (>50%) located cranially to the apex of their major curve. Only 29% had a syrinx that spanned the curve apex. In patients whose curves remained stable over time (+ 10 degrees), 44% had a syrinx that spanned the apex of their curve. This is compared to 18% of patients with improvement in curve and 29% of patients with worsening of curve. In patients whose curves worsened, 100% had the most of their syrinx located cranial to the apex of the curve, compared to 80% of those whose curves remained stable/improved. There was no significant difference in syrinx length or width between those whose curves remained stable or improved & those whose curves progressed.

Conclusion:

In idiopathic syrinx and scoliosis, the bulk of the syrinx is located cranially to the apex of the curve in most patients, regardless of whether the curve remained stable, progressed, or improved. There was no significant association between syrinx length & width and curve progression.