Use of percutaneous endoscopy to place syringopleural or cystoperitoneal cerebrospinal fluid shunts: technical note.
The authors describe a technique for percutaneous endoscopic shunt placement to treat clinically symptomatic spinal cysts. Seven patients underwent the procedure--five with syringomyelia, one with a symptomatic perineurial cyst, and one with a large arachnoid cyst. In all patients the shunt was successfully placed, and clinical improvement occurred in six. In four patients the entire procedure was performed endoscopically, whereas in three conversion to an open surgical exposure was required for safe access of a syrinx cavity. Overall, however, the pleural or peritoneal catheter was successfully placed endoscopically in all seven patients. There were two cases of postoperative positional headaches of which one required valve revision. In one case the catheter migrated and required repositioning. Percutaneous endoscopic shunt placement appears feasible in appropriately selected patients.
Guest
James D
JD
Department of Neurological Surgery, University of Miami, Miami, Florida 33136, USA. jguest@med.miami.edu
Silbert
Lisa
L
Casas
Carlos E
CE
D000328:Adult; D016080:Arachnoid Cysts; D002408:Catheters, Indwelling; D002557:Cerebrospinal Fluid Shunts; D004724:Endoscopy / Q000379:methods*; D004868:Equipment Failure; D005471:Fluoroscopy; D006261:Headache / Q000209:etiology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010537:Peritoneum; D010994:Pleura; D011183:Postoperative Complications; D011187:Posture; D011300:Preoperative Care; D013595:Syringomyelia / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D052958:Tarlov Cysts / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*