Purpose: This phase II clinical trial aims to evaluate the indications, therapeutic effects and side effects of thalidomide in refractory syringomyelia. Primary outcome measure: The primary endpoint is the change of ASIA at week 12. The clinical efficacy is defined as ASIA increase ≥ 1 at week 12, as compared with that before thalidomide usage.
The pathogenesis of syringomyelia is poorly understood and duraplasty or shunting is not always effective. Although it is generally thought that syringomyelia is simply an accumulation of CSF from the subarachnoid space, the pathogenesis is likely to be more complex and may involve cellular and molecular processes. The investigators supposed that blood spinal cord barrier(BSCB) might play a key role in the pathogenesis of syringomyelia, especially post-traumatic syringomyelia(PTS), and that thalidomide, as an BSCB protection-related drug, would reduce BSCB damage and protect BSCB in syringomyelia. Primary objectives: This phase II clinical trial aims to evaluate the indications, therapeutic effects and safety of thalidomide in refractory syringomyelia.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
30
Thalidomide 50 - 200 mg once at nightime
Fengzeng Jian
Beijing, Beijing City, China
RECRUITINGASIA Score
American Spinal Injury Association(ASIA) Score for evaluating the spinal cord function, degree of the spinal cord function, motor1-100, sensory 1-224, higher scores mean a better outcome
Time frame: 1 day before and 3 days, 3 months after drug treatment
syringomyelia remission
syringomyelia remission is defined as ≥ 25% reduction in syringomyelia volume on T2 images at week 12, as compared with that before thalidomide usage
Time frame: 1 day before and 3 days, 3 months after drug treatment
The evoked electromyographic signal (eEMG) potential
The evoked electromyographic signal (eEMG) potential is the standard index
Time frame: 1 day before and 3 days, 3 months after drug treatment
Visual Analog Scale (VAS)
degree of the pain, 1-10, higher scores mean a worse outcome
Time frame: 1 day before and 3 days, 3 months after drug treatment
Klekamp and Sammi syringomyelia scale
for evaluating the spinal cord function, higher scores mean a better outcome
Time frame: 1 day before and 3 days, 3 months after drug treatment
modified Japanese Orthopaedic Association Scores (mJOA)
Motor function, sensory, bladder function;for evaluating the spinal cord function;0-17, higher scores mean a better outcome
Time frame: 1 day before and 3 days, 3 months after drug treatment
xuanwu syringomyelia scale
for evaluating the spinal cord function, for evaluating the spinal cord function;0-18, higher scores mean a worse outcome
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Time frame: 1 day before and 3 days, 3 months after drug treatment
Incidence of complications
Incidence of complications
Time frame: 1 day before and 3 days, 3 months after drug treatment