Management of scoliosis and syringomyelia in children.

Scoliosis is often a characteristic of an underlying syrinx. Surgical treatment, in particular instrumentation, of scoliosis in a child with an unrecognized syrinx may be associated with an increased risk of neurologic complications. The effect of syrinx treatment on scoliosis is yet to be clearly determined. Since 1976, nine children with scoliosis and a syrinx have been treated at a major pediatric referral center. Follow-up averaged 4 years 9 months. The average increase in curve size was 12 degrees (range 2 degrees -43 degrees ). The syrinx was treated operatively in five children. One child, who underwent foramen magnum decompression, required surgical stabilization of the spine. No neurologic complications were encountered. A compilation of reported cases in the literature was performed and analyzed. This analysis of 98 cases revealed that treatment of the syrinx resulted in no further progression of the scoliosis in 35 of 80 (48%) cases in which the curve history was reported. Surgical stabilization of the curve was required in 27 (31%) cases without neurologic complications.