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Open AccessReview
Optimizing Therapeutic Strategies for Syringomyelia Associated with Tethered Cord Syndrome: A Comprehensive Review
by
Mohammad Mohsen Mosleh
Mohammad Mohsen Mosleh 1 and
Moon-Jun Sohn
Moon-Jun Sohn 1,2,*
1
Department of Medicine, Graduate School of Medicine, Inje University, 75 Bokji-ro, Busanjin-gu, Busan 47392, Republic of Korea
2
Department of Neurosurgery, Neuroscience and Radiosurgery Hybrid Research Center, Inje University Ilsan Paik Hospital, College of Medicine, Juhwa-ro 170, Ilsanseo-gu, Goyang City 10380, Republic of Korea
*
Author to whom correspondence should be addressed.
Children 2024, 11(8), 961; https://doi.org/10.3390/children11080961 (registering DOI)
Submission received: 17 July 2024
/
Revised: 3 August 2024
/
Accepted: 8 August 2024
/
Published: 9 August 2024
Abstract
This review highlights the need for therapeutic guidelines for syringomyelia associated with tethered cord syndrome (TCS) caused by spinal dysraphism (SD). A comprehensive literature review was conducted, selecting twelve articles to analyze common therapeutic strategies. Surgical cord untethering alone has recently become a preferred treatment, with 45 ± 21.1% of patients experiencing remission or improvement, 47 ± 20.4% unchanged and asymptomatic, and 4 ± 8% worsened. Untethering with direct surgical drainage for the syrinx had better outcomes than untethering alone (78% vs. 45%, p = 0.05). Terminal syringostomy was beneficial for syrinxes extending to the filum terminale but not for asymptomatic small syrinxes with a syrinx index < 0.4. Syrinx shunting was recommended for symptomatic large syrinxes (>2 cm in length and syrinx index > 0.5). Various shunt procedures for syrinxes are still advocated, mainly for refractory syringomyelia in Chiari malformation, posttraumatic cases, SD, or other causes. Personalized surgical methods that address the root cause of syringomyelia, particularly those improving cerebrospinal fluid flow, offer promising results with minimized complications. Ongoing studies are required to enhance management strategies for syringomyelia associated with TCS, optimize patient outcomes, and reduce the risk of recurrent symptoms.
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MDPI and ACS Style
Mosleh, M.M.; Sohn, M.-J.
Optimizing Therapeutic Strategies for Syringomyelia Associated with Tethered Cord Syndrome: A Comprehensive Review. Children 2024, 11, 961.
https://doi.org/10.3390/children11080961
AMA Style
Mosleh MM, Sohn M-J.
Optimizing Therapeutic Strategies for Syringomyelia Associated with Tethered Cord Syndrome: A Comprehensive Review. Children. 2024; 11(8):961.
https://doi.org/10.3390/children11080961
Chicago/Turabian Style
Mosleh, Mohammad Mohsen, and Moon-Jun Sohn.
2024. "Optimizing Therapeutic Strategies for Syringomyelia Associated with Tethered Cord Syndrome: A Comprehensive Review" Children 11, no. 8: 961.
https://doi.org/10.3390/children11080961
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