{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T03:47:56Z","timestamp":1779162476300,"version":"3.51.4"},"reference-count":65,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T00:00:00Z","timestamp":1746057600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Syringomyelia is a complex neurological disorder characterized by a fluid-filled cavity (syrinx) within the spinal cord, frequently resulting from altered cerebrospinal fluid (CSF) dynamics. While its clinical manifestations are diverse, orthopedic complications such as scoliosis, pes cavus, and Charcot arthropathy may represent early diagnostic clues yet are often under-recognized. Methods: This comprehensive review synthesizes the current literature on the pathophysiology, clinical presentation, diagnostic strategies, and management approaches of syringomyelia, with a specific emphasis on its orthopedic manifestations. Additionally, we present a detailed case of neuropathic shoulder arthropathy associated with advanced syringomyelia. Results: Orthopedic involvement in syringomyelia includes progressive spinal deformities and neurogenic joint destruction, particularly affecting the shoulder and elbow. Scoliosis is frequently observed, especially in association with Chiari malformations, and may precede neurologic diagnosis. Charcot joints result from impaired proprioception and protective sensation. The case presented illustrates the diagnostic challenges and therapeutic dilemmas in managing advanced neuro-orthopedic complications in syringomyelia. Conclusions: Syringomyelia should be considered in the differential diagnosis of atypical musculoskeletal presentations. Early recognition and multidisciplinary management are essential to prevent irreversible orthopedic sequelae. Conservative treatment remains the mainstay in stable cases, while surgery is reserved for progressive disease. Orthopedic assessment plays a pivotal role in the diagnostic pathway and long-term care of affected patients.<\/jats:p>","DOI":"10.3390\/jcm14093145","type":"journal-article","created":{"date-parts":[[2025,5,1]],"date-time":"2025-05-01T09:16:12Z","timestamp":1746090972000},"page":"3145","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Orthopedic Manifestations of Syringomyelia: A Comprehensive Review"],"prefix":"10.3390","volume":"14","author":[{"given":"Mohamad","family":"Fadila","sequence":"first","affiliation":[{"name":"Orthopedic Department, Meir Medical Center, Kfar Saba, Affiliated to Faculty of Health Sciences and Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geva","family":"Sarrabia","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Meir Medical Center, Kfar Saba, Affiliated to Faculty of Health Sciences and Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5532-2590","authenticated-orcid":false,"given":"Shay","family":"Shapira","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Meir Medical Center, Kfar Saba, Affiliated to Faculty of Health Sciences and Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eyal","family":"Yaacobi","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Meir Medical Center, Kfar Saba, Affiliated to Faculty of Health Sciences and Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4646-8659","authenticated-orcid":false,"given":"Yuval","family":"Baruch","sequence":"additional","affiliation":[{"name":"Spine Surgery Unit, Meir Medical Center, Affiliated to Faculty of Health Sciences and Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0201-172X","authenticated-orcid":false,"given":"Itzhak","family":"Engel","sequence":"additional","affiliation":[{"name":"Spine Surgery Unit, Meir Medical Center, Affiliated to Faculty of Health Sciences and Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4429-7067","authenticated-orcid":false,"given":"Nissim","family":"Ohana","sequence":"additional","affiliation":[{"name":"Orthopedic Department, Meir Medical Center, Kfar Saba, Affiliated to Faculty of Health Sciences and Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"},{"name":"Spine Surgery Unit, Meir Medical Center, Affiliated to Faculty of Health Sciences and Medicine, Tel-Aviv University, Tel Aviv 6997801, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/j.neurol.2020.07.004","article-title":"Syringomyelia and hydromyelia: Current understanding and neurosurgical management","volume":"177","author":"Leclerc","year":"2021","journal-title":"Rev. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"E15","DOI":"10.3171\/2011.9.FOCUS11198","article-title":"Idiopathic syringomyelia: Retrospective case series, comprehensive review, and update on management","volume":"31","author":"Roy","year":"2011","journal-title":"Neurosurg. Focus"},{"key":"ref_3","first-page":"2685","article-title":"Atypical presentation of syringomyelia mimicking as motor neuron disease: A case report","volume":"4","author":"Sabellano","year":"2023","journal-title":"Clin. Imag. Med. Case Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"367","DOI":"10.3171\/2012.8.SPINE111059","article-title":"Pathophysiology of primary spinal syringomyelia","volume":"17","author":"Heiss","year":"2012","journal-title":"J. Neurosurg. Spine"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2127","DOI":"10.1007\/s00701-014-2229-z","article-title":"Syringomyelia: A practical, clinical concept for classification","volume":"156","author":"Blegvad","year":"2014","journal-title":"Acta Neurochir."},{"key":"ref_6","first-page":"48","article-title":"Syringomyelia and Chiari Syndrome Registry: Advances in epidemiology, clinical phenotypes and natural history based on a North Western Italy cohort","volume":"56","author":"Ciaramitaro","year":"2020","journal-title":"J. Neurosurg. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1136\/practneurol-2021-002994","article-title":"Syringomyelia: Diagnosis and management","volume":"21","author":"Flint","year":"2021","journal-title":"Pr. Neurol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"501","DOI":"10.1016\/j.nec.2015.06.006","article-title":"Prevalence of Chiari I malformation and syringomyelia","volume":"26","author":"Kahn","year":"2015","journal-title":"Neurosurg. Clin. N. Am."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"161","DOI":"10.3171\/2014.10.PEDS14295","article-title":"Pediatric and adult Chiari malformation Type I surgical series 1965\u20132013: A review of demographics, operative treatment, and outcomes","volume":"15","author":"Arnautovic","year":"2015","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"802","DOI":"10.3171\/jns.1995.82.5.0802","article-title":"Pathological basis of spinal cord cavitation in syringomyelia: Analysis of 105 autopsy cases","volume":"82","author":"Milhorat","year":"1995","journal-title":"J. Neurosurg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"619","DOI":"10.3171\/2019.7.SPINE181139","article-title":"Chiari malformation and syringomyelia: JNSPG 75th anniversary invited review article","volume":"31","author":"Holly","year":"2019","journal-title":"J. Neurosurg. Spine"},{"key":"ref_12","first-page":"28","article-title":"Magnetic resonance imaging\u2013based measures predictive of short-term surgical outcome in patients with Chiari malformation Type I: A pilot study","volume":"26","author":"Alperin","year":"2017","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1179\/016164104225017956","article-title":"The tethered cord syndrome in adults with spina bifida occulta","volume":"26","author":"Lapsiwala","year":"2004","journal-title":"Neurol. Res."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Mosleh, M.M., and Sohn, M.-J. (2024). Optimizing Therapeutic Strategies for Syringomyelia Associated with Tethered Cord Syndrome: A Comprehensive Review. Children, 11.","DOI":"10.3390\/children11080961"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"695","DOI":"10.1038\/sc.2012.35","article-title":"Factors associated with early onset post-traumatic syringomyelia","volume":"50","author":"Ko","year":"2012","journal-title":"Spinal Cord."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1007\/s00701-005-0645-9","article-title":"Chiari malformation: CSF flow dynamics in the craniocervical junction and syrinx","volume":"147","author":"Sakas","year":"2005","journal-title":"Acta Neurochir."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1111\/j.1939-1676.2006.tb02884.x","article-title":"Syringomyelia: Current concepts in pathogenesis, diagnosis, and treatment","volume":"20","author":"Rusbridge","year":"2006","journal-title":"J. Vet. Intern. Med."},{"key":"ref_18","first-page":"318","article-title":"Update on the pathophysiology and management of syringomyelia unrelated to Chiari malformation","volume":"34","author":"Giner","year":"2019","journal-title":"Neurocirugia"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1093\/neurosurgery\/6.CN_suppl_1.131","article-title":"The mechanism of syringomyelia and its surgical correction","volume":"6","author":"Gardner","year":"1959","journal-title":"Neurosurgery"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/S0140-6736(72)92152-6","article-title":"Pathogenesis of syringomyelia","volume":"300","author":"Ball","year":"1972","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"3","DOI":"10.3171\/jns.1994.80.1.0003","article-title":"Pathophysiology of syringomyelia associated with Chiari I malformation of the cerebellar tonsils: Implications for diagnosis and treatment","volume":"80","author":"Oldfield","year":"1994","journal-title":"J. Neurosurg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"E2","DOI":"10.3171\/foc.2000.8.3.2","article-title":"Mechanisms underlying the formation and enlargement of noncommunicating syringomyelia: Experimental studies","volume":"8","author":"Stoodley","year":"2000","journal-title":"Neurosurg. Focus"},{"key":"ref_23","first-page":"CASE21341","article-title":"Syringomyelia intermittens: Highlighting the complex pathophysiology of syringomyelia. Illustrative case","volume":"2","author":"Harding","year":"2021","journal-title":"J. Neurosurg. Case Lessons"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1007\/s00701-002-0944-3","article-title":"The pathophysiology of syringomyelia\u2014Historical overview and current concept","volume":"144","author":"Klekamp","year":"2002","journal-title":"Acta Neurochir."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s10067-022-06332-7","article-title":"Charcot arthropathy of elbow due to syringomyelia: A case series and systematic review of literature","volume":"42","author":"Parida","year":"2023","journal-title":"Clin. Rheumatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"791","DOI":"10.31616\/asj.2020.0216","article-title":"Pattern of Syringomyelia in Presumed Idiopathic and Congenital Scoliosis","volume":"15","author":"Mohanty","year":"2021","journal-title":"Asian Spine J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1515\/folmed-2017-0099","article-title":"Progressive Scoliosis and Syringomyelia\u2014Questions of Surgical Approach","volume":"60","author":"Mikhaylovskiy","year":"2018","journal-title":"Folia Medica"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2192","DOI":"10.4103\/0028-3886.359263","article-title":"Scoliosis and Syringomyelia","volume":"70","author":"Goel","year":"2022","journal-title":"Neurol. India"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"314","DOI":"10.1302\/0301-620X.61B3.158024","article-title":"Orthopaedic features in the presentation of syringomyelia","volume":"61-B","author":"Williams","year":"1979","journal-title":"J. Bone Jt. Surgery. Br."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e729","DOI":"10.1016\/j.wneu.2017.12.156","article-title":"How should syringomyelia be defined and diagnosed?","volume":"111","author":"Klekamp","year":"2018","journal-title":"World Neurosurg."},{"key":"ref_31","first-page":"93","article-title":"Syringomyelia mimicking as bibrachial variant of motor neuron disease","volume":"72","author":"Ralot","year":"2024","journal-title":"J. Assoc. Physicians India"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"S245","DOI":"10.1097\/BRS.0b013e3181f32e9c","article-title":"Surgical management of post-traumatic syringomyelia","volume":"35","author":"Bonfield","year":"2010","journal-title":"Spine"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1007\/BF00314649","article-title":"The natural history and results of surgery in 50 cases of syringomyelia","volume":"238","author":"Mariani","year":"1991","journal-title":"J. Neurol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1136\/vr.103234","article-title":"Comparison of gabapentin versus topiramate on clinically affected dogs with Chiari-like malformation and syringomyelia","volume":"177","author":"Plessas","year":"2015","journal-title":"Vet. Rec."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.vaa.2019.09.007","article-title":"Pregabalin alleviates clinical signs of syringomyelia-related central neuropathic pain in Cavalier King Charles Spaniel dogs: A randomized controlled trial","volume":"47","author":"Thoefner","year":"2020","journal-title":"Veter-Anaesth. Analg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1111\/j.1471-4159.2005.03263.x","article-title":"Evidence that gabapentin reduces neuropathic pain by inhibiting the spinal release of glutamate","volume":"94","author":"Coderre","year":"2005","journal-title":"J. Neurochem."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"16A","DOI":"10.1155\/2006\/651712","article-title":"Gabapentin and Pregabalin for the Treatment of Neuropathic Pain: A Review of Laboratory and Clinical Evidence","volume":"11","author":"Gilron","year":"2006","journal-title":"Pain Res. Manag."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1016\/j.seizure.2005.11.005","article-title":"Pregabalin: A new antiepileptic drug for refractory epilepsy","volume":"15","author":"Hamandi","year":"2006","journal-title":"Seizure"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.tvjl.2015.10.045","article-title":"Evaluation of the effect of oral omeprazole on canine cerebrospinal fluid production: A pilot study","volume":"209","author":"Girod","year":"2016","journal-title":"Vet. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1136\/inp.m1869","article-title":"New considerations about Chiari-like malformation, syringomyelia and their management","volume":"42","author":"Rusbridge","year":"2020","journal-title":"Practice"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1136\/adc.84.1.68","article-title":"Use of acetazolamide to decrease cerebrospinal fluid production in chronically ventilated patients with ventriculopleural shunts","volume":"84","author":"Carrion","year":"2001","journal-title":"Arch. Dis. Child."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.rapm.2005.04.010","article-title":"Systemic meloxicam reduces tactile allodynia development after L5 single spinal nerve injury in rats","volume":"30","author":"Takahashi","year":"2005","journal-title":"Reg. Anesth. Pain Med."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.tvjl.2006.12.007","article-title":"Pathophysiology and treatment of neuropathic pain associated with syringomyelia","volume":"175","author":"Rusbridge","year":"2008","journal-title":"Vet. J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1017\/S0317167100004236","article-title":"Methadone in the Management of Intractable Neuropathic Noncancer Pain","volume":"32","author":"Moulin","year":"2005","journal-title":"Can. J. Neurol. Sci."},{"key":"ref_45","first-page":"115","article-title":"Syringopleural shunt insertion using a minimally invasive approach: Technical note, case series, and review of the literature","volume":"6","author":"Yang","year":"2021","journal-title":"J. Minim. Invasive Spine Surg. Tech."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1038\/sc.2010.17","article-title":"Surgical treatment of post-traumatic syringomyelia","volume":"48","author":"Ushewokunze","year":"2010","journal-title":"Spinal Cord."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"157","DOI":"10.46292\/sci2603-157","article-title":"A Primary Care Provider\u2019s Guide to Spasticity Management in Spinal Cord Injury","volume":"26","author":"Cabahug","year":"2020","journal-title":"Top. Spinal Cord. Inj. Rehabil."},{"key":"ref_48","first-page":"1742","article-title":"Spasticity following spinal cord injury","volume":"132","author":"Rekand","year":"2012","journal-title":"Tidsskr. Nor. Laegeforen"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1177\/1545968309343213","article-title":"Management of spasticity after spinal cord injury: Current techniques and future directions","volume":"24","author":"Elbasiouny","year":"2010","journal-title":"Neurorehabil Neural Repair."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.rehab.2017.10.001","article-title":"Non-pharmacological interventions for spasticity in adults: An overview of systematic reviews","volume":"62","author":"Khan","year":"2019","journal-title":"Ann. Phys. Rehabil. Med."},{"key":"ref_51","unstructured":"McMahon, M. (2017). Physical Therapy Management and Treatment of a Patient with Post-Traumatic Syringomyelia. [Ph.D. Thesis, University of Iowa]."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.wneu.2014.06.044","article-title":"Arachnolysis or cerebrospinal fluid diversion for adult-onset syringomyelia? A systematic review of the literature","volume":"83","author":"Ghobrial","year":"2015","journal-title":"World Neurosurg."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1212\/WNL.0000000000003130","article-title":"Spontaneous resolution of an extensive posttraumatic syrinx","volume":"87","author":"Killeen","year":"2016","journal-title":"Neurology"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Albright, L., Pollack, I.F., Adelson, D., Abbott, R., Adamson, D.C., Alden, T.D., and Yang, M. (2008). Principles and Practice of Pediatric Neurosurgery, Thieme.","DOI":"10.1055\/b-002-57134"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1007\/s00381-003-0882-2","article-title":"International survey on the management of Chiari I malformation and syringomyelia","volume":"20","author":"Schijman","year":"2004","journal-title":"Child\u2019s Nerv. Syst."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1227\/01.NEU.0000083591.22113.CB","article-title":"Tailored operative technique for Chiari type I malformation using intraoperative color Doppler ultrasonography","volume":"53","author":"Milhorat","year":"2003","journal-title":"Neurosurgery"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1055\/s-0033-1357362","article-title":"Persistent\/recurrent syringomyelia after Chiari decompression\u2014Natural history and management strategies: A systematic review","volume":"04","author":"Zhang","year":"2013","journal-title":"Evid.-Based Spine-Care J."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"118","DOI":"10.3171\/PED\/2008\/1\/2\/118","article-title":"Time course of syringomyelia resolution following decompression of Chiari malformation Type I","volume":"1","author":"Wetjen","year":"2008","journal-title":"J. Neurosurg. Pediatr."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"133","DOI":"10.14444\/7020","article-title":"Syringo-subarachnoid shunt placement: A minimally invasive technique using fixed tubular retractors\u2014Three case reports and literature review","volume":"14","author":"Srikantha","year":"2020","journal-title":"Int. J. Spine Surg."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"102","DOI":"10.17116\/jnevro201711731102-106","article-title":"Treatment of syringomyelia associated with Chiari 1 malformation","volume":"117","author":"Zuev","year":"2017","journal-title":"Zhurnal Nevrol. I Psikhiatrii im. S.S. Korsakova"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/j.asjsur.2022.06.150","article-title":"Outcome predictors and clinical presentation of syringomyelia","volume":"46","author":"Zheng","year":"2023","journal-title":"Asian J. Surg."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Yuan, C., Guan, J., Du, Y., Fang, Z., Wang, X., Yao, Q., Zhang, C., Liu, Z., Wang, K., and Duan, W. (2022). Neurological deterioration after posterior fossa decompression for adult syringomyelia: Proposal for a summarized treatment algorithm. Front. Surg., 9.","DOI":"10.3389\/fsurg.2022.968906"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1016\/j.jse.2016.10.015","article-title":"Charcot shoulder and elbow: A review of the literature and update on treatment","volume":"26","author":"Snoddy","year":"2017","journal-title":"J. Shoulder Elb. Surg."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1007\/s00296-022-05234-w","article-title":"Neuropathic arthropathy of the shoulder secondary to operated syringomyelia: A case-based review","volume":"43","author":"Kocyigit","year":"2023","journal-title":"Rheumatol. Int."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1007\/s00590-021-03102-0","article-title":"Shoulder arthropathy secondary to syringomyelia: Case series of 10 patients","volume":"32","author":"Wawrzyniak","year":"2022","journal-title":"Eur. J. Orthop. Surg. Traumatol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/9\/3145\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:25:52Z","timestamp":1760030752000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/9\/3145"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,1]]},"references-count":65,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["jcm14093145"],"URL":"https:\/\/doi.org\/10.3390\/jcm14093145","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,1]]}}}