Treatment of Holocord Syringomyelia-Chiari Complex by Posterior Fossa Decompression and a Syringosubarachnoid Shunt in a Single-Stage Single Approach.
Acta Neurochir Suppl
; 125: 133-138, 2019.
Article
in En
| MEDLINE
| ID: mdl-30610313
ABSTRACT
BACKGROUND:
Posterior fossa decompression with expansive duraplasty is the first-line surgical approach for the treatment of symptomatic syringomyelia associated with Chiari malformation. Despite good decompression, the clinical failure rate is reported to be up to 26%. A syringosubarachnoid (S-S) shunt may be used as a secondary option.METHODS:
In this paper we describe a single-institution experience of three cases of holocord syringomyelia-Chiari complex treated with foramen magnum decompression, expansive duraplasty and an S-S shunt carried out in a single-stage single approach. Following a standard suboccipital craniectomy, patients were submitted to syrinx fenestration and simultaneous insertion of an S-S shunt through a 1-mm posterior midline myelotomy at the C2 level prior to expansive dural reconstruction.RESULTS:
Postoperative imaging showed immediate reduction of the holocord cavities. Preoperative neurological deficits rapidly improved significantly and were stabilized at follow-up.CONCLUSION:
In our experience the positioning of the shunt catheter at a high level of the spinal cord (C2) did not add a significant risk of morbidity and obviated the need for a second operation and/or a separate incision in cases of clinical failure. This technique avoided the risk associated with a second surgery and its morbidity, and allowed prompt clinical recovery.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Arnold-Chiari Malformation
/
Syringomyelia
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Cerebrospinal Fluid Shunts
/
Decompressive Craniectomy
Limits:
Humans
Language:
En
Year:
2019
Type:
Article