Natural history of scoliosis in children with syringomyelia

We performed a retrospective review of 27 scoliotic patients with syringomy elia using MRI. Their mean age at the first MRI examination was 10.9 years, and at the final review 15.8 years. The mean ratio of the diameter of the syrinx to the cord on the midsagittal MRI (S/C ratio) decreased from 0.49 t o 0.24; 14 patients showed a decrease of 50% or more (reduction group). In this reduction group, the cerebellar tonsillar herniation decreased from a mean of 11.3 mm to 6.0 mm, and some improvement in dissociated sensory dist urbance was seen in nine of 13 patients. The scoliosis improved by 5 degree s or more in six patients in the reduction group, Our results indicate that spontaneous shrinkage of syringomyelia in children is not unusual and is a ssociated with improvement in the tonsillar herniation, the scoliosis and t he neurological deficit.