Background: 

Both patients with Chiari-I malformation (CIM) with syringomyelia and those with idiopathic syringomyelia (ISm) have a syrinx and can have scoliosis as well. However, there is no literature regarding differences between CIM and ISm in terms of radiographic outcomes and surgical complications after posterior fusion, to our knowledge. The aim of the present study was to compare radiographic features, clinical outcomes, and surgical complications after posterior spinal fusion between patients with CIM-associated scoliosis and those with ISm-associated scoliosis.

Methods: 

One hundred and twenty patients with syringomyelia-associated scoliosis were retrospectively analyzed. Twenty-one patients with scoliosis secondary to CIM were enrolled and matched by sex, age, and the Cobb angle of the scoliotic curve with 21 patients with scoliosis secondary to ISm. All patients underwent 1-stage posterior fusion surgery. Coronal and sagittal radiographic parameters were evaluated before surgery, immediately after surgery, and at the final follow-up (at least 2 years). We also collected data regarding syringeal features, neurological deficits, intraoperative neuromonitoring, and complications.

Results: 

Sex, age, preoperative coronal/sagittal scoliosis parameters, and neurological deficits were similar between the matched CIM and ISm groups. On average, the CIM group had a longer syrinx (12.3 ± 3.6 versus 8.9 ± 4.5 vertebral levels, p = 0.010) than the ISm group. The CIM and ISm groups showed similar correction rates for primary curves (70.9% ± 10.6% versus 69.5% ± 16.3%, p = 0.739). There were no significant differences in coronal/sagittal correction, intraoperative neuromonitoring abnormalities, surgical complications, or Scoliosis Research Society-22 questionnaire scores between the 2 groups.

Conclusions: 

Despite matched demographic and scoliotic coronal parameters, patients with CIM had longer syrinxes compared with patients with ISm. One-stage posterior fusion achieved comparable clinical and radiographic outcomes for both CIM- and ISm-associated scoliosis without significant differences in neurological complications.

Level of Evidence: 

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

中文翻译：

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脊髓空洞症与特发性脊髓空洞症的Chiari-I畸形的外科脊柱侧弯矫正。

背景： 

患有脊髓空洞症的Chiari-I畸形（CIM）患者和患有特发性脊髓空洞症（ISm）的患者均患有syrinx，也可能患有脊柱侧弯。然而，据我们所知，目前尚无文献报道CIM和ISm在后路融合后的影像学结果和手术并发症方面的差异。本研究的目的是比较CIM相关脊柱侧凸患者和ISm相关脊柱侧凸患者后路脊柱融合术后的影像学特征，临床结局和手术并发症。

方法： 

回顾性分析了120例脊髓空洞相关的脊柱侧弯患者。纳入21例CIM继发性脊柱侧弯患者，并按性别，年龄和脊柱侧弯曲线的Cobb角与21例ISm继发性脊柱侧弯患者进行匹配。所有患者均接受一期后路融合手术。在手术前，手术后以及最后的随访（至少2年）中评估冠状位和矢状位影像学参数。我们还收集了有关注射器功能，神经功能缺损，术中神经监测和并发症的数据。

结果： 

匹配的CIM和ISm组之间的性别，年龄，术前冠状/矢状脊柱侧弯参数和神经功能缺损相似。平均而言，CIM组的syrinx比ISm组更长（12.3±3.6 vs 8.9±4.5椎骨水平，p = 0.010）。CIM和ISm组的主要曲线校正率相似（70.9％±10.6％对69.5％±16.3％，p = 0.739）。两组之间的冠状/矢状位矫正，术中神经监测异常，手术并发症或脊柱侧弯研究学会-22问卷得分没有显着差异。

结论： 

尽管人口统计和脊柱侧弯冠状动脉参数匹配，但与ISm患者相比，CIM患者的syrinxes更长。对于CIM和ISm相关的脊柱侧弯，一期后路融合术在临床和影像学上均取得了可比的结果，神经系统并发症无明显差异。

证据级别： 

预后III级。有关证据水平的完整说明，请参见《作者说明》。