Syringomyelia secondary to degenerative spinal canal stenosis: a systematic review.
完整摘要 · 中文译文
脊髓空洞症最常与Chiari畸形、创伤后脊髓损伤、髓内肿瘤或蛛网膜炎相关。其与退变性椎管狭窄并存的情况不常见，其自然史和结局仍缺乏充分特征描述。为综合关于继发于退变性椎管狭窄（主要为颈椎病，少数为胸椎黄韧带骨化病例）的脊髓空洞症的患者层面证据，探讨其临床表现、影像学、管理和结局，并分别考察有症状和无症状表型。按照PRISMA 2020对PubMed、Scopus、Embase和Cochrane Library自建库至2026年1月31日的系统评价。方法学质量采用Joanna Briggs研究所清单进行评估。患者层面数据以比例形式进行描述性综合；未进行荟萃分析合并。本评价在PROSPERO进行了回顾性注册（CRD420261379566）。12项研究贡献了28例患者（平均年龄54.9岁，范围33-81；男18例，女10例）；一例机构索引病例单独呈现，并排除于所有分母之外。12例患者（42.9%）无症状并接受保守管理；16例（57.1%）有症状，最常见为运动无力（75.0%）、感觉缺损（50.0%）和疼痛（37.5%）。仅行硬膜外减压后报告的影像学消退为7/12（58%）——前路2/3，后路5/9；唯一一例附加硬膜内分流者为孤立病例，未计入该数字。继发于退变性椎管狭窄的脊髓空洞症罕见，且其supp 现有证据质量低，且以单病例报告为主。报告的主要策略是解除致病性狭窄的硬膜外减压，而非初次空洞引流。在唯一规模足以探讨该问题的回顾性系列中，偶然发现的无症状性脊髓空洞在连续影像学检查中保持稳定或消退；这一观察结果需要独立证实。
完整摘要 · 英文原文
Syringomyelia is most often associated with Chiari malformation, post-traumatic cord injury, intramedullary tumours or arachnoiditis. Its occurrence with degenerative spinal canal stenosis is uncommon, and its natural history and outcomes remain poorly characterised. To synthesise patient-level evidence on syringomyelia secondary to degenerative spinal canal stenosis (mostly cervical spondylosis, with a few thoracic ossified ligamentum flavum cases), addressing presentation, radiology, management and outcomes, and examining the symptomatic and asymptomatic phenotypes separately. PRISMA 2020 systematic review of PubMed, Scopus, Embase and the Cochrane Library from inception to 31 January 2026. Methodological quality was appraised with the Joanna Briggs Institute checklists. Patient-level data were synthesised descriptively as proportions; no meta-analytic pooling was performed. The review was retrospectively registered with PROSPERO (CRD420261379566). Twelve studies contributed 28 patients (mean age 54.9 years, range 33-81; 18 men, 10 women); an institutional index case is presented separately and excluded from all denominators. Twelve patients (42.9%) were asymptomatic and managed conservatively; 16 (57.1%) were symptomatic, most often with motor weakness (75.0%), sensory deficits (50.0%) and pain (37.5%). Reported radiographic regression after extradural decompression alone was 7/12 (58%) - 2/3 anterior, 5/9 posterior; the single case with added intradural shunting was isolated from this figure. Syringomyelia secondary to degenerative spinal canal stenosis is rare and supported by a low-quality evidence base dominated by single-patient case reports. Extradural decompression of the causative stenosis - rather than primary cavity drainage - is the predominant reported strategy. In the only retrospective series large enough to address the question, incidental asymptomatic syrinxes remained stable or regressed on serial imaging; this observation requires independent confirmation.
摘要 待译
Syringomyelia is most often associated with Chiari malformation, post-traumatic cord injury, intramedullary tumours or arachnoiditis. Its occurrence with degenerative spinal canal stenosis is uncommon, and its natural history and outcomes remain poorly characterised. To synthesise patient-level evidence on syringomyelia secondary to degenerative spinal canal stenosis (mostly cervical spondylosis, with a few thoracic ossified ligamentum flavum cases), addressing presentation, radiology, management and outcomes, and examining the symptomatic and asymptomatic phenotypes separately.…