Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
Book Review
Brief Report
Case Letter
Case Report
Case Series
Commentary
Current Issue
Editorial
Erratum
Guest Editorial
Images
Images in Neurology
Images in Neuroscience
Images in Neurosciences
Letter to Editor
Letter to the Editor
Letters to Editor
Letters to the Editor
Media and News
None
Notice of Retraction
Obituary
Original Article
Point of View
Position Paper
Review Article
Short Communication
Systematic Review
Systematic Review Article
Technical Note
Techniques in Neurosurgery
View/Download PDF

Translate this page into:

Commentary
5 (
Suppl 1
); S82-S82

Commentary

Department of Orthopaedic Surgery, University of Miyazaki, Miyazaki, Japan
Address for correspondence: Dr. Hiroshi Kuroki, Department of Orthopaedic Surgery, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki - 889 1692, Japan. E-mail: hiroshik@med.miyazaki-u.ac.jp

Read COMMENTARY-ARTICLE associated with this -

Licence

This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Disclaimer:
This article was originally published by Medknow Publications & Media Pvt Ltd and was migrated to Scientific Scholar after the change of Publisher.

In this article, the authors introduced a rare case of sylingomyelia secondary to cervical spondylosis.[1] Further, they performed literature review and discovered only 15 cases of other sylingomyelia secondary to spinal cord compression. Although sylingomyelia associated with Chiari malformation is occasionally encountered, these cases are extremely uncommon. Therefore, I guess this paper should be published because of rarity.

However, a couple of questions are still remaining unresolved.

It is broadly well known that sylingomyelia associated with Chiari malformation sometimes causes scoliosis.[23] The prevalence of scoliosis accompanied with sylingomyelia was previously reported 2.8-25.8%.[456] Whereas, the prevalence of sylingomyelia secondary to spinal cord compression is unknown.

The authors speculated the pathophysiology of sylingomyelia secondary to spinal cord compression by bibliographic consideration. But the discussion of pathophysiology of sylingomyelia is also incomplete because most diseases by spinal cord compression do not always have sylingomyelia. In the sylingomyelia associated with Chiari malformation, overcrowding in the posterior cranial fossa due to a normal-sized hindbrain induces a downward herniation of the brain as well as occlusion of cerebrospinal fluid (CSF) flow across the foramen magnum.[7] This obstructs natural flow of CSF and may be responsible for the origin and maintenance of syringomyelia by the pulsatile pressure waves forcing CSF into the spinal cord through the perivascular and interstitial spaces.[8] Moreover, some sylingomyelia associated with Chiari malformation are spontaneously diminishing. In scoliosis cases, Tokunaga et al.[9] reported the size of sylingomyelia associated with Chiari malformation decreased 50% or more in 14 of 27 cases in accordance with growth that promotes elevation of the tonsils.

The next step that we should do is accumulation of similar cases. Amassed data must contribute to properly elucidate prevalence, mechanism, and established management of this disorder. I hope various questions with regard to this pathology will be solved in the future.

References

  1. , , , , . Syringomyelia secondary to cervical spondylosis – A case report and review of literature. J Neurosci Rural Pract. 2014;5:S78-82.
    [Google Scholar]
  2. , , , , , . Scoliosis associated with syringomyelia. Spine (Phila Pa 1976). 1993;18:1591-2.
    [Google Scholar]
  3. , , , , , . Single-group study to explore the optimal management of neuropathic scoliosis caused by neural axis abnormalities based on its clinical features. The Open Spine Journal. 2012;4:28-33.
    [Google Scholar]
  4. , , , , , , . MRI of “idiopathic” juvenile scoliosis. A prospective study. J Bone Joint Surg Br. 1996;78:314-7.
    [Google Scholar]
  5. , , , , , . Routine preoperative MRI and SEP studies in adolescent idiopathic scoliosis. J Pediatr Orthop. 1996;16:350-3.
    [Google Scholar]
  6. , , , . Incidence of neural axis abnormalities in infantile and juvenile patients with spinal deformity. Is a magnetic resonance image screening necessary? Spine (Phila Pa 1976). 1998;23:206-10.
    [Google Scholar]
  7. , , , , , . Pathogenesis of Chiari malformation: A morphometric study of the posterior cranial fossa. J Neurosurg. 1997;86:40-7.
    [Google Scholar]
  8. , , , , . Pathophysiology of syringomyelia associated with Chiari I malformation of the cerebellar tonsils. J Neurosurg. 1994;80:3-15.
    [Google Scholar]
  9. , , , , , , . Natural history of scoliosis in children with sylingomyelia. J Bone Joint Surg Br. 2001;83:371-6.
    [Google Scholar]

    Fulltext Views
    347

    PDF downloads
    340
    View/Download PDF
    Download Citations
    BibTeX
    RIS
    Show Sections