Study and Surgical Treatment of Syringomyelia
关键词
抽象
描述
Objective: The goal of this study is to establish the mechanism(s) of progression of primarily spinal syringomyelia (PSS), the type of syringomyelia that is associated with pathology in the spinal column and not at the craniocervical junction. Our hypothesis is that when a lesion obstructs the spinal subarachnoid space, it shortens the segment of spinal canal that dampens the CSF pressure waves that are produced with each heartbeat and creates enlarged spinal subarachnoid pressure waves that act on the spinal cord above the block to drive CSF into the spinal cord and create a syrinx. After a syrinx is formed, enlarged subarachnoid pressure waves compress the external surface of the spinal cord, propel the syrinx fluid, and promote syrinx progression.
Study Population: Subjects will have primary spinal syringomyelia associated with 1) intradural scarring which is post-traumatic, post-inflammatory, or post-operative, 2) intradural-extramedullary masses such as arachnoid cysts or meningiomas, and 3) extramedullary-extradural spinal lesions such as cervical spondylosis or spinal deformity, or 4) an intramedullary tumor.
Design: Subjects will have testing before and after standard surgical therapy of syringomyelia. Testing includes measurement of CSF pressure, neurologic examination, CT-myelography, and MR scanning. Results of CSF pressure measurements before surgery will be compared to measurements from normal controls that were previously studied. The effect of surgery on CSF pressure, neurologic examination, CT-myelography, and MRI scans will be evaluated.
Outcome Measures: The primary outcome measure is cervical CSF pulse pressure, which is the amplitude of the CSF pressure wave, compared to normal values. Secondary outcomes measures include change in CSF pulse pressure, neurologic examination, CT-myelography, and MRI scans between before and after surgery.
日期
最后验证: | 05/17/2011 |
首次提交: | 02/13/2001 |
提交的预估入学人数: | 02/13/2001 |
首次发布: | 02/14/2001 |
上次提交的更新: | 06/29/2017 |
最近更新发布: | 07/01/2017 |
实际学习开始日期: | 02/07/2001 |
预计完成日期: | 05/17/2011 |
状况或疾病
相
资格标准
有资格学习的年龄 | 18 Years 至 18 Years |
有资格学习的性别 | All |
接受健康志愿者 | 是 |
标准 | - INCLUSION CRITERIA: To be eligible to participate in this research study, the subject must: Be 18 years of age or older. Have syringomyelia documented by MRI. Have evidence of neurological deterioration related to syringomyelia or spinal cord tumor. Prior surgery for syringomyelia does not result in exclusion from study. Be able to comprehend the risks of testing and therapy and to give informed consent. EXCLUSION CRITERIA: Subjects will not eligible to participate in this research study if: They are pregnant (because X-rays might injure a fetus). They cannot have an MRI scan as determined by a radiologist. They have a problem with bleeding that cannot be corrected. They are unable to understand the risks of the testing and surgical therapy. Their blood test for HIV (the virus that causes AIDS) is positive, because a positive HIV test would increase your risk of infection from research testing. They have syringomyelia which developed after meningitis, because we have found that laminectomy and duroplasty is ineffective in this setting |