Syringomyelia treated with a nonvalved syringoperitoneal shunt: a follow-up study.
OBJECTIVE
Eighteen patients with syringomyelia received nonvalved syringoperitoneal shunts during the years 1987 through 1996. In 15 cases, the fistulae were multicompartmental, either separated by segments of normal cord or septated.


METHODS
Even in the multicystic cases, only one syringeal catheter was introduced, usually into the caudalmost cavity. Access to the fistula was obtained via a midline myelotomy, which was performed in an area at which the spinal cord overlying the fistula was at its thinnest.


RESULTS
The progressive clinical course of syringomyelia was arrested in all patients. Surgery resulted in improvement for 11 patients. Five patients remained unchanged without further progression. Two patients became worse as the result of new deficits caused by surgery. In four patients, the myelotomy lead to new but discrete sensory loss of minor importance. Postoperative magnetic resonance images showed a rapid and persistent collapse of all fistulae in all patients.


CONCLUSIONS
We conclude that syringoperitoneal shunting is favorable in patients with large fistulae. In patients with Chiari malformations, the procedure may be a second alternative to foramen magnum decompression.
Lund-Johansen
M
M
Department of Neurosurgery, Haukeland Hospital, Bergen, Norway.
Wester
K
K
D000293:Adolescent; D001139:Arnold-Chiari Malformation / Q000175:diagnosis / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination; D011183:Postoperative Complications / Q000175:diagnosis; D013595:Syringomyelia / Q000175:diagnosis / Q000601:surgery*; D017287:Ventriculoperitoneal Shunt / Q000295:instrumentation*