Syringosubarachnoid shunt for treatment of syringomyelia

Vaquero, Jesús; Martínez, R.; Salazar, J; Santos, H

doi:10.1007/bf01418834

Cited by 44 publications

(14 citation statements)

References 13 publications

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“…One patient developed postoperative meningitis and an intramedullary abscess at the tip of the shunt catheter despite adequate antibiotic treatment. Therefore, we are unable to substantiate reports which recommend shunting as the method of choice in Chiari I malformation with syringomyelia [31,35,61].…”

Section: Results For Shunting Of the Syrinxcontrasting

confidence: 56%

The surgical treatment of Chiari I malformation

et al. 1996

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A retrospective study was undertaken on 133 patients with a Chiari I malformation treated within the last 16 years at the Departments of Neurosurgery at the Nordstadt Hospital Hannover, Germany, and the University of California, Los Angeles, U.S.A. Ninety-seven patients presented with symptoms related to accompanying syringomyelia and 4 with associated syringobulbia. They underwent 149 surgical procedures and were followed for a mean of 39 +/- 52 months. A decompression at the foramen magnum was performed in 124 patients, while 22 of those with syringomyelia were treated by shunting (7 syringosubarachnoid shunts, 15 syringoperitoneal or -pleural shunts), and 3 by ventriculoperitoneal shunts for hydrocephalus. Except for ventriculoperitoneal shunting, at least a short-term decrease in size of an associated syrinx was observed for all procedures in the majority of cases. However, no long-term benefit was observed for syrinx shunting operations. The best clinical long-term results were obtained with decompression of the foramen magnum in patients with (86% free of a clinical recurrence) and without syringomyelia (77% free of a clinical recurrence). We advise against syrinx shunting, a large craniectomy, and obex plugging which are associated with higher recurrence rates. Instead, surgery should consist of a small craniectomy, opening of the dura, archnoid dissection to establish normal cerebrospinal fluid (CSF) outflow from the 4th ventricle, and a fascia lata dural graft.

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Section: Results For Shunting Of the Syrinxcontrasting

confidence: 56%

The surgical treatment of Chiari I malformation

et al. 1996

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“…However, with recent progress in microsurgical technique subarachnoid shunt has been again receiving syringoattention [21][22][23]. In this report, the authors stress that the syringo-subarachnoid shunt is effective as a surgical procedure for syringomyelia associated with Chiari malformation.…”

Section: Introductionmentioning

confidence: 79%

Syringo-subarachnoid shunt for syringomyelia associated with Chiari malformation (type 1)

Isu¹,

Iwasaki²,

Akino³

et al. 1990

Acta neurochir

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The authors report the surgical results of 28 patients with syringomyelia associated with Chiari malformation (type 1). 28 patients underwent 34 operative procedures. Syringo-subarachnoid shunt was performed in 28 patients, foramen magnum decompression with syringo-subarachnoid shunt in three, ventriculo-peritoneal shunt in one, terminal syringostomy in one, and foramen magnum decompression with terminal syringostomy in one. In an average postoperative follow-up period of 3 years and 9 months ranging from one year to 7 years and one month, neurological symptoms and signs improved in 24 out of 28 patients (82%). Some improvement was noted in sensory deficit and motor weakness. In 3 patients, the symptoms did not change. In 3 patients whose symptoms were unchanged, preoperative studies demonstrated atrophy of the spinal cord, in which irreversible changes were shown. The symptoms deteriorated in one patient. In one patient whose symptoms increased 3 months after syringo-subarachnoid shunt, shunt insufficiency due to postoperative adhesive arachnoiditis was responsible for neurological deterioration. The authors propose that syringo-subarachnoid shunt is effective as a surgical procedure for syringomyelia associated with Chiari malformation (type 1) if the patient does not have symptoms due to Chiari malformation or has only mild signs and symptoms which do not require foramen magnum decompression, such as nystagmus or atrophy of sternocleidomastoid muscle.

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“…Longne [17] reported that simple decompression of the posterior fossa should give results similar to the surgical procedure involving the syrinx. Some authors [22,5] think that a more rational approach would be an extramedullary shunt since the syrinx comes under pulsatile pressure from extraspinal structures during coughing and laughing, and increasing pressure from abdominal tension. Some authors [22,5] think that a more rational approach would be an extramedullary shunt since the syrinx comes under pulsatile pressure from extraspinal structures during coughing and laughing, and increasing pressure from abdominal tension.…”

Section: Discussionmentioning

confidence: 99%

Natural history and postsurgical outcome of syringomyelia

et al. 1991

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The surgical treatment of syringomyelia is still debatable and the result are often poor. Several surgical procedures, based on various proposed etiopathologies, have been developed but in many cases have proved completely ineffective. We have evaluated the follow-up of 69 syringomyelic patients, some operated on, some not, in the search for clues to the management of the disease. For this purpose we devised a rating system, which we describe. 31 patients underwent surgery while 38 received no treatment. We found that half of the patients deteriorated, whether they were operated on or not; only 1 in 5 improved and the rest remained stable. For surgical treatment to be successful, the disease must be in rapid evolution but without definite paraparesis.

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Syringosubarachnoid shunt for treatment of syringomyelia

Cited by 44 publications

References 13 publications

The surgical treatment of Chiari I malformation

The surgical treatment of Chiari I malformation

Syringo-subarachnoid shunt for syringomyelia associated with Chiari malformation (type 1)

Natural history and postsurgical outcome of syringomyelia

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