Critical Evaluation of MRI and Percutaneous Ultrasound Following Spinal Intra- and Extramedullary Shunting: Long-term Results After Drainage Procedure of Syringomyella and Cystic Lesions in 21 Patients

  • A. Aschoff
  • A. Löhlein
  • U. Mende
  • H. Betz
Conference paper

Abstract

In 1891 Abbe and Coley were the first to treat syringomyelia by surgery, and in 1926 Puusepp published the first report on a series with surgical interventions in syringomyelia (Table 1). The results were encouraging. Nevertheless, until the 1970s, surgical procedures in syringomyelia were rarely performed. The syringomyelia in ArnoldChiari malformation was one of the classic indications for operation. However, surgeons discussed for many years whether syringomyelia may be associated with trauma or not. The diagnostic revolution of CTassisted myelography and even more so that of MRI provided reliability in the diagnosis of syringomyelia. A fair number of posttraumatic intramedullary cysts were thus diagnosed, and the number of surgical interventions consequently increased. In a total of 350 publications, 3591 cases of syringomyelia have been reported, and 1803 of these patients underwent a surgical procedure. Therefore, the number of operated cases has increased threefold since Levy’s publication in 1983.

Keywords

Catheter Tuberculosis Syringe Neurol Cavitation 

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References

  1. [1]
    Abbe R, Coley W B (1892) Syringomyelia. Operation exploration of cord, withdrawal of fluid, exhibition of patient. J Nerv Ment Dis 19: 512–520CrossRefGoogle Scholar
  2. [2]
    Adelstein L J (1938) The surgical treatment of syringomyelia. Amer J Surg 40: 384–395CrossRefGoogle Scholar
  3. [3]
    Alvisi C, Cerisoli M (1984) Long-term results of the surgical treatment of syringohydromyelia. Acta Neurochir 71: 133–140PubMedCrossRefGoogle Scholar
  4. [4]
    Aschoff A, Löhlein A, Kunze S (1986) Die posttraumatische Sy-ringomyelie — Behandlungsergebnisse von sechs Drainageoperatio-nen mit besonderer Berücksichtigung von prä-und postoperativen NMR-Befunden. Vortrag 37. Jahrestagung der Dt. Gesellschaft für Neurochirurgie 1986Google Scholar
  5. [5]
    Barbaro N M, Wilson Ch B, Gutin Ph H, Edwards MSB (1984) Surgical treatment of syringomyelia. Favorable results with syringoperitoneal shunting. J Neurosurg 61: 531–538PubMedCrossRefGoogle Scholar
  6. [6]
    Ballantine H T, Ojemann R G, Drew J H (1971) Syringohydro-myelia. Prog Neurol Surg 4: 227–245Google Scholar
  7. [7]
    Breig A (1960) Biomechanics of the central nervous system. Almquist and Wiksell, StockholmGoogle Scholar
  8. [8]
    Calbucci F, Andreoli A, Bollini C, Tognetti F, Godano U, Testa C (1987) Surgical treatment of syringomyelia. Clinical results and post-operative M.R.I. controls. Lecture, 8th European Con-gress of NeurosurgeryGoogle Scholar
  9. [9]
    Dworkin G E, Staas W E (1985) Posttraumatic syringomyelia. Arch Phys Med Rehabil 66: 329–331PubMedGoogle Scholar
  10. [10]
    Eisberg C A (1916) Diseases of the spinal cord and its mem-branes. Saunders, PhiladelphiaGoogle Scholar
  11. [11]
    Fischer E G, Welch K, Shillito J (1977): Syringomyelia following lumbouretral shunting for communicating hydrocephalus. Report of three cases. J Neurosurg 47: 96–100PubMedCrossRefGoogle Scholar
  12. [12]
    Frazier Ch H, Rowe S N (1936) The surgical treatment of syringo-myelia. Annals of Surgery 103: 481–497PubMedCentralPubMedCrossRefGoogle Scholar
  13. [13]
    Hertel G, Ricker K (1977) A geomedical study of the distribution of syringomyelia in Germany. Proceedings of the 11th Worlds Congress of Neurology. Excerpta Medica Congress Series No 434 Neurology 353–365Google Scholar
  14. [14]
    Lesoin F, Petit H, Thomas C E, Viaud C, Baleriaux D, Jomin M (1986) Use of the syringoperitoneal shunt in the treatment of syringomyelia. Surg Neurol 25: 131–136PubMedCrossRefGoogle Scholar
  15. [15]
    Levy W J, Mason L, Hahn J F (1983) Chiari malformation presenting in adults: A surgical experience in 127 cases. Neurosurgery 12: 377–390PubMedCrossRefGoogle Scholar
  16. [16]
    MacDonald R L, Findlay J M, Tator Ch H (1988) Microcystic spinal cord degeneration causing posttraumatic myelopathia. J Neuro-surg 68: 466–471Google Scholar
  17. [17]
    Pecker J (1983) La derivation syringoperitonéale. Neurochirur-gie (F) 29: 171–173Google Scholar
  18. [18]
    Peiper H (1931) Die operative Behandlung der Syringomyelie. Nervenarzt 4: 436–453Google Scholar
  19. [19]
    Phillips T W, Kindt G W (1981) Syringoperitoneal shunt for sy-ringomyelia: A preliminary report. Surg Neurol 16: 462–466PubMedCrossRefGoogle Scholar
  20. [20]
    Puusepp L (1926) Traitement and operatoire de la syringomyélie Rev Neurolog 1: 1171–1179Google Scholar
  21. [21]
    Quencer R M, Green B A, Eismont F J (1983): Posttraumatic spinal cord cysts. Clinical features and characterisation with metri-zamide computed tomography. Radiology 146: 415–423PubMedGoogle Scholar
  22. [22]
    Roosen N, Lumenta C B, Lins E, Stork W, Gahlen D, Bock W J (1987) Magnetic resonance imaging in the management of syringo-myelia: Diagnosis and postoperative results. Lecture on 8th European Congress of NeurosurgeryGoogle Scholar
  23. [23]
    Rossier A B, Foo D, Shillito J, Dyro F M (1985) Posttraumatic cervical syringomyelia. Brain 108: 439–461PubMedCrossRefGoogle Scholar
  24. [24]
    Schlesinger E B, Antunes J L, Michelsen W J, Louis K M (1981) Hydromyelia: Clinical presentation and comparison of modalities of treatment. Neurosurgery 9: 356–365PubMedCrossRefGoogle Scholar
  25. [25]
    Shannon N, Symon L, Logue V, Cull D, Rang J, Kendall B (1981) Clinical features, investigation and treatment of posttraumatic syringomyelia. J Neurol Neurosurg Psych 44: 35–42CrossRefGoogle Scholar
  26. [26]
    Shillito J (1978) The treatment of intramedullary syrinx of the cervical cord by T-tube drainage. Neurosurgery 2: 171–172Google Scholar
  27. [27]
    Stevens J M, Olney J S, Kendall B E (1985) Post-traumatic cystic and non-cystic myelopathy. Neuroradiology 27: 48–56PubMedCrossRefGoogle Scholar
  28. [28]
    Sullivan L P, Stears J C, Ringel S P (1988): Resolution of sy-ringomyelia and Chiari I malformation by ventriculoatrial shunting in a patient with pseudotumor cerebri and a lumboperi-toneal shunt. Neurosurg 22: 744–747CrossRefGoogle Scholar
  29. [29]
    Suzuki M, Davis Ch, Symon L, Gentili F (1985) Syringoperitoneal shunt for treatment of cord cavitation. J Neurol Neurosurg Psychiat 48: 620–627PubMedCentralPubMedCrossRefGoogle Scholar
  30. [30]
    Tator C H, Meguro K, Rowed D W (1982) Favourable results with syringosubarachnoid shunts for treatment of syringomyelia. J Neurosurg 56: 517–523PubMedCrossRefGoogle Scholar
  31. [31]
    Vaquero J, Martinez R, Salazar J, Santos H (1987) Syringosub-arachnoid shunt for treatment of syringomyelia. Acta Neurochir 84: 105–109PubMedCrossRefGoogle Scholar
  32. [32]
    Vernon J D, Silver J R, Symon L (1983) Post-traumatic syringo-myelia: The results of surgery. Paraplegia 21: 37–46PubMedCrossRefGoogle Scholar
  33. [33]
    Welch K, Shillito J, Strand R, Fischer E G, Winston K R (1981) Chiari I “malformation” — an acquired disorder? J Neurosurg 55: 604–609PubMedCrossRefGoogle Scholar
  34. [34]
    Williams B, Terry A F, Jones F, McSweeney T (1981) Syringomyelia as a sequel to traumatic paraplegia. Paraplegia 19: 67–80PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1989

Authors and Affiliations

  • A. Aschoff
  • A. Löhlein
  • U. Mende
  • H. Betz

There are no affiliations available

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