Intraoperative measurement of spinal cord blood flow in syringomyelia.
The role of spinal cord ischemia in the pathophysiology of syringomyelia remains undetermined. Previous reports in the literature suggest that shunting of syringes can improve spinal cord blood flow. In order to determine the effects of syrinx decompression on spinal cord blood flow in patients with syringomyelia, we prospectively measured regional spinal cord blood flow (RSCBF) intraoperatively pre and post shunting in patients with symptomatic syringomyelia using laser doppler flowmetry. Six patients with MRI documented syringomyelia were studied (three with Arnold Chiari I malformation and associated syrinx and three with post-traumatic syringomyelia). Surgery was performed on all patients with either a syringopleural or syringoperitoneal shunt. Laser doppler blood flow and somatosensory evoked potentials were monitored prior to myelotomy and after shunt insertion. Results indicate that there was a significant increase in RSCBF after decompression of the syrinx. This study supports the hypothesis that spinal cord ischemia is important in the pathophysiology of syringomyelia and confirms previous reports in the literature regarding RSCBF in syringomyelia.
Young
W F
WF
Department of Neurosurgery, Temple University School of Medicine, 3401 North Broad Street, Philadelphia, PA 19140, USA. wyoung@astro.ocis.temple.edu
Tuma
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R
O'Grady
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T
D000328:Adult; D001139:Arnold-Chiari Malformation / Q000150:complications; D002557:Cerebrospinal Fluid Shunts; D019299:Decompression, Surgical; D005073:Evoked Potentials, Somatosensory; D005260:Female; D006801:Humans; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011446:Prospective Studies; D012039:Regional Blood Flow; D013116:Spinal Cord / Q000098:blood supply* / Q000503:physiopathology / Q000601:surgery; D013119:Spinal Cord Injuries / Q000150:complications; D020760:Spinal Cord Ischemia / Q000503:physiopathology*; D013595:Syringomyelia / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery