SYRINGOMYELIA - A POTENTIAL RISK FACTOR IN SCOLIOSIS SURGERY

Study Design. An 18-year-old patient with ''idiopathic'' adolescent sc oliosis is presented. A thoracic syrinx was detected as an incidental finding during magnetic resonance imaging of the spine. Objectives. Sy ringomyelia may be a risk factor for neurologic injury during correcti on of scoliosis, and in these cases, spinal cord monitoring may be of particular value. Background Data. Spinal distraction and instrumentat ion carry a risk of neurologic damage in patients with scoliosis and a ssociated syringomyelia. Syringomyelia is a cause of scoliosis, and al though neurologic problems are the usual symptom, scoliosis may be the only sign at initial examination. A higher risk of neurologic injury has been reported in corrective surgical treatment of patients with sy ringomyelia. The mechanism of cord damage is unclear. Monitoring of sp inal cord function is recommended to detect intraoperative neurologica l injury, which may be reversed on removing distraction and implants. Results. Intraoperative somatosensory-evoked potential (SSEP) spinal c ord monitoring detected possible cord damage during outrigger distract ion. Reduction of distraction led to a recovery of SSEPs and a satisfa ctory operative outcome.Conclusion. Syringomyelia may be a risk factor for neurologic injury during correction of scoliosis, and SSEP spinal cord monitoring may identify and prevent intraoperative spinal cord i njury.