The Bernard Williams Memorial Lecture
How can we define syringomyelia and measure results of its treatment?
Syringomyelia is considered as a fluid filled cavitation inside the spinal cord. However, there is no agreement on how syringomyelia should be differentiated from other cystic pathologies of the spinal cord. Syringomyelia is the result of a long disease process. Good short-term results of surgical treatment are important for surgeons and patients. However, the real criterion of successful treatment has to be whether the neurological disease can be controlled long-term. But how should long-term results be documented? How long do we need to follow patients before we may consider their condition safe? Among 3206 patients with spinal cord pathologies, identified between 1991 and 2015, 2276 patients demonstrated cystic features. Syringomyelia was differentiated from cystic intramedullary tumours, glioependymal cysts, myelomalacias and dilatations of the central canal by clinical and radiological criteria. The diagnosis of syringomyelia should be reserved for patients with a fluid filled cavity in the spinal cord related to either a disturbance of CSF flow, spinal cord tethering or an intramedullary tumour. For patients in whom such a relation cannot be established, the diagnosis of syringomyelia should be withheld. Treatment of syringomyelia requires us to treat the underlying cause. Long-term results of surgical procedures and the natural history should be analysed by determining progression-free survival rates to account for varying follow-up times. If different treatment modalities are to be compared, such statistics will reveal differences within 5 years.
The symposium is co-organised by The Ann Conroy Trust, in association with Aesculap Academia.
The Ann Conroy Trust is Registered Charity No: 1165808.
We provide Support, Education and Research for patients living with Chiari Malformation, Syringomyelia and associated conditions.