A critical appraisal of syrinx cavity shunting procedures.
OBJECTIVE
This study was conducted to evaluate the results of shunting procedures for syringomyelia.


METHODS
In a follow-up analysis of 42 patients in whom shunts were placed in syringomyelic cavities, the authors have demonstrated that 21 (50%) developed recurrent cyst expansion indicative of shunt failure. Problems were encountered in patients with syringomyelia resulting from hindbrain herniation, spinal trauma, or inflammatory processes. A low-pressure cerebrospinal fluid state occurred in two of 18 patients; infection was also rare (one of 18 patients), but both are potentially devastating complications of shunt procedures. Shunt obstruction, the most common problem, was encountered in 18 patients; spinal cord tethering, seen in three cases, may account for situations in which the patient gradually deteriorated neurologically, despite a functioning shunt.


CONCLUSIONS
Placement of all types of shunts (subarachnoid, syringoperitoneal, and syringopleural) may be followed by significant morbidity requiring one or more additional surgical procedures.
Division of Neurosurgery, University of California, Los Angeles, USA.
U
U
Batzdorf
J
J
Klekamp
J P
JP
Johnson
D015170:Cerebrospinal Fluid Pressure / Q000502:physiology; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D004677:Encephalocele / Q000150:complications; D004868:Equipment Failure; D005069:Evaluation Studies as Topic; D005402:Fistula / Q000209:etiology / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008581:Meningitis / Q000150:complications; D012008:Recurrence; D012086:Reoperation; D012249:Rhombencephalon / Q000473:pathology; D013116:Spinal Cord / Q000473:pathology; D013118:Spinal Cord Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D013124:Spinal Injuries / Q000150:complications; D013595:Syringomyelia / Q000209:etiology / Q000601:surgery*; D016896:Treatment Outcome