Pain Pattern in Patients with Scoliosis and Syringomyelia

Purpose: The goal was to investigate the pattern of pain in patients with scoliosis [SC] associated with syringomyelia [SM].

Methods: One hundred nineteen patients with SC associated with SM were investigated. Mean follow-up was 11.8 years.

Results: SM related pain occurred in 70 out of 119 patients (59%) at presentation, at the average age of 18.1 years (range, 3.1-47.6 years). Backache, headache, and neck pain were the most common types of pain in 47.1%, 32.9%, and 28.6% of patients, respectively. The presence and severity of an ACM had a significant correlation with the presence of headache (p=0.027). Likewise, headache was also more common among patients with MM (p=0.032). In only 23 cases (19.3%) pain was present at time of diagnosis of SC. In 47 cases (39.5%) SM related pain occurred after the time of diagnosis of SC, at an average of 11.7±9.7 years (range, 0.1-44.5 years). Pain alone or together with neurological symptoms were the main indications for a MRI in 12 and 28 patients, respectively. Among 70 patients with pain, 32 cases still had some pain at late follow-up. No significant correlation between size of syrinx and the presence of pain existed (p>0.05). The only relationship between the location of syrinx and type of pain was that presence of leg pain correlated with a lower located syrinx (p<0.05).

Conclusions: Syringomyelia should be considered as a differential diagnosis in scoliosis patients with pain. Most patients had some pain at late follow-up despite treatment. Leg pain was mainly found in patients with terminal syrinxes. No correlation between syrinx size and pain existed.