Deprecated: Optional parameter $post_id declared before required parameter $field is implicitly treated as a required parameter in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/api/api-value.php on line 270

Deprecated: Optional parameter $value declared before required parameter $field is implicitly treated as a required parameter in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/api/api-value.php on line 398

Deprecated: Optional parameter $post_id declared before required parameter $field is implicitly treated as a required parameter in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/api/api-value.php on line 398

Deprecated: Optional parameter $post_id declared before required parameter $field is implicitly treated as a required parameter in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/api/api-value.php on line 483

Deprecated: Creation of dynamic property ACF::$fields is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/fields.php on line 136

Deprecated: Creation of dynamic property ACF::$locations is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/locations.php on line 130

Deprecated: Optional parameter $key declared before required parameter $data is implicitly treated as a required parameter in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/cache.php on line 399

Deprecated: Creation of dynamic property ACF::$cache is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/cache.php on line 281

Deprecated: Creation of dynamic property ACF::$deprecated is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/deprecated.php on line 228

Deprecated: Creation of dynamic property ACF::$json is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/json.php on line 185

Deprecated: Creation of dynamic property ACF::$local is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/local.php on line 884

Deprecated: Creation of dynamic property acf_loop::$loops is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/loop.php on line 26

Deprecated: Creation of dynamic property ACF::$loop is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/loop.php on line 270

Deprecated: Creation of dynamic property ACF::$revisions is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/revisions.php on line 413

Deprecated: Creation of dynamic property acf_validation::$errors is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/validation.php on line 26

Deprecated: Creation of dynamic property ACF::$validation is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/validation.php on line 212

Deprecated: Optional parameter $key declared before required parameter $value is implicitly treated as a required parameter in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/ajax/class-acf-ajax.php on line 99

Deprecated: Creation of dynamic property acf_form_customizer::$preview_values is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/forms/form-customizer.php on line 26

Deprecated: Creation of dynamic property acf_form_customizer::$preview_fields is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/forms/form-customizer.php on line 27

Deprecated: Creation of dynamic property acf_form_customizer::$preview_errors is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/forms/form-customizer.php on line 28

Deprecated: Creation of dynamic property ACF::$form_front is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/forms/form-front.php on line 664

Deprecated: Creation of dynamic property acf_form_widget::$preview_values is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/forms/form-widget.php on line 34

Deprecated: Creation of dynamic property acf_form_widget::$preview_reference is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/forms/form-widget.php on line 35

Deprecated: Creation of dynamic property acf_form_widget::$preview_errors is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/forms/form-widget.php on line 36

Deprecated: Creation of dynamic property acf_field_oembed::$width is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/fields/class-acf-field-oembed.php on line 31

Deprecated: Creation of dynamic property acf_field_oembed::$height is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/fields/class-acf-field-oembed.php on line 32

Deprecated: Creation of dynamic property acf_field_google_map::$default_values is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/fields/class-acf-field-google-map.php on line 33

Deprecated: Creation of dynamic property acf_field__group::$have_rows is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/includes/fields/class-acf-field-group.php on line 31

Deprecated: Optional parameter $i declared before required parameter $post_id is implicitly treated as a required parameter in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/pro/fields/class-acf-field-repeater.php on line 715

Deprecated: Optional parameter $i declared before required parameter $post_id is implicitly treated as a required parameter in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/pro/fields/class-acf-field-repeater.php on line 781

Deprecated: Optional parameter $name declared before required parameter $field is implicitly treated as a required parameter in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/pro/fields/class-acf-field-flexible-content.php on line 1052

Deprecated: Optional parameter $i declared before required parameter $post_id is implicitly treated as a required parameter in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/pro/fields/class-acf-field-flexible-content.php on line 1088

Deprecated: Optional parameter $i declared before required parameter $post_id is implicitly treated as a required parameter in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/pro/fields/class-acf-field-flexible-content.php on line 1140

Deprecated: Optional parameter $id declared before required parameter $field is implicitly treated as a required parameter in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/pro/fields/class-acf-field-gallery.php on line 300

Deprecated: Creation of dynamic property acf_field_clone::$cloning is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/pro/fields/class-acf-field-clone.php on line 34

Deprecated: Creation of dynamic property acf_field_clone::$have_rows is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/advanced-custom-fields-pro/pro/fields/class-acf-field-clone.php on line 35

Deprecated: Creation of dynamic property JSON_API::$query is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/json-api/singletons/api.php on line 6

Deprecated: Creation of dynamic property JSON_API::$introspector is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/json-api/singletons/api.php on line 7

Deprecated: Creation of dynamic property JSON_API::$response is deprecated in /nas/content/live/csfflowdev/wp-content/plugins/json-api/singletons/api.php on line 8
The dilemma and burden of incidental and asymptomatic syrinxes – CSF Flow

The dilemma and burden of incidental and asymptomatic syrinxes

Background

Syringomyelia and cord cysts despite frequently being idiopathic and asymptomatic, are a cause of anxiety and cost. No published large clinical series have demonstrated their evolution when managed conservatively.

Aims

  • To assess current UK practice.
  • To review patients seen at the South West Neurosurgical Centre and establish local management and follow up practice.
  • To review radiological and clinical change.

Methods

A follow up practice questionnaire was sent to members of the UK, British Syringomyelia and Chiari Group. Locally, demographic data, contributory pathology, follow up duration, radiological and clinical outcome and MRI parameters were recorded for patients diagnosed with syringomyelia from 2002 to 2017. The cohort was divided according to whether surgery was undertaken.

Results

14% of responding BSCG members do not follow up conservatively managed syrinxes irrespective of appearance.

64% follow up even asymptomatic dilated central canals. Size and loculations were radiological features precipitating follow up imaging.

97 patients at the South West Neurosurgical Centre were reviewed.

67 patients were managed conservatively (32 with an idiopathic syrinx, 22 with a Chiari malformation, 3 with dysraphism, 4 with tumours, 4 with a history of trauma, and 1 post infective).

57% had a craniovertebral decompression.

Follow-up imaging was present for 81 patients. In the conservatively managed cohort syrinx size was unchanged in 82%, reduced in 10% and increased in 8%. We present the common radiological characteristics of the groups. Median follow up duration was 24 months.

Conclusions

Surgeons make decisions on asymptomatic syrinx follow up based on personal experience and perhaps practice defensive medicine. A larger retrospective review and prospective longitudinal study are proposed as a way of attaining predictive information with respect to clinical presentation, precipitant, and radiological appearance which will allow health care providers to suitably advise and monitor patients.