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.
Batzdorf
U
U
Division of Neurosurgery, University of California, Los Angeles, USA.
Klekamp
J
J
Johnson
J P
JP
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