PMC8035583_01
Prevalence of preoperative signs and symptoms
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F1
CM-1 associated with a holocord syringomyelia was found [Figure 1a-c]. CSF pathways. Concomitantly, the syrinx dilated in a caudad direction showed a jet CSF flow toward more caudal metameres [Figure 1d]. Conversely, during diastole, the signal inside the syrinx became hypointense as a consequence of the cranial direction of the CSF flow, and the upper part of the syrinx re-expanded. At the 1st month of evaluation, the symptoms disappeared almost completely, and the cine MRI revealed a dramatic reduction of the caudad flow inside the syrinx during systole [Figure 1e and Video 1].
PMC8035583_02
Spinal cord metameric involvment
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F2
A CM-1 was found, with a C2-T1 syrinx [Figure 2a and b]. Preoperative cine MRI clearly showed a caudad hyperintense signal inside the syrinx during systole [Figure 2c]. During diastole, a tenuous hypointense signal was visible inside the syrinx as a consequence of the cephalad CSF flow [Figure 2d]. The postoperative cine MRI was performed 48 h after surgery revealed a significant attenuation of the systolic signal inside the syrinx [Figure 2e]. The same signal was found to be almost disappeared at the 1st-month evaluation [Figure 2f and Video 2].
PMC8035583_03
Trend of signs and symptoms of treated patients
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F3
A 37-year-old male with a severe spinal deformity was diagnosed with a CM-1 and a concomitant C2-C7 syringomyelia [Figure 3a]. Cine MRI revealed a caudal CSF jet flow inside the syrinx during systole [Figure 3b and Video 3]. After PFD, the sagittal extension and the AP diameter of the syrinx collapsed already in the early postoperative evaluation [Figure 3c]. Cine MRI performed at the 2nd month showed the disappearance of the systolic signal inside the syrinx [Figure 3d and Video 4].
Syrinx lenght
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F4
Cine MRI performed at the 2nd month showed the disappearance of the systolic signal inside the syrinx [Figure 3d and Video 4].