Turkish Neurosurgery 2014 , Vol 24 , Num 4
Posttraumatic Syringomyelia: A Technical Note
Ali Fahir OZER1, Hosein Jafari MARANDI2, Mehdi SASANI2, Tunc OKTENOGLU2, Tuncer SUZER2
1Koc University, School of Medicine, Department of Neurosurgery, Istanbul, Turkey
2American Hospital, Department of Neurosurgery, Istanbul, Turkey
DOI : 10.5137/1019-5149.JTN.8609-13.1 AIM: Previous studies have not identified a preferred surgical technique to treat posttraumatic syringomyelia. Both syringopleural shunting and arachnoidolysis are used in neurosurgery practice for the surgical treatment of posttraumatic syringomyelia. In this study, we present a new technique designed to achieve a better outcome following surgery.

MATERIAL and METHODS: A 33-year-old man, who exhibited pain and spasticity below the thoracic region after a traffic accident that occurred 16 years ago, was treated with a new technique. He also had paraparesis and urinary incontinency before the surgery. The initial cervicothoracic Magnetic Resonance Imaging (MRI) scans showed the development of a syrinx in the T4-5 region. A syringopleural shunt and bilateral subarachnoid to subarachnoid catheters from proximal to distal zones of the syrinx were performed under surgical microscope.

RESULTS: The operative time was 90 minutes, and the blood loss was approximately 100 mL. The patient was mobilized on postoperative day 2 and was discharged 4 days after surgery with mild improvement of his preoperative symptoms. Postoperative MRI scans revealed partial regression at 6 months and complete decompression of the syrinx at 3 years follow-up without any clinical symptoms.

CONCLUSION: This is a report of minimal-access insertion combining syringopleural with subarachnoid-subarachnoid bypass shunt insertion. This minimally invasive technique seems to be an effective and safe method. Keywords : Posttraumatic syringomyelia, Shunt surgery, Magnetic resonance imaging, Subarachnoid-subarachnoid bypass, Cervical spinal cord

Corresponding author : Ali Fahir Ozer, alifahirozer@gmail.com