A D Levi1, V K Sonntag. 1. Division of Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona, USA.
Abstract
STUDY DESIGN: A patient in whom posttraumatic syringomyelia developed 34 years after an L2 fracture is reported. OBJECTIVES: To review the pathophysiology and current management modalities for posttraumatic syringomyelia. The delayed presentation and management rationale of this case are emphasized. SUMMARY OF BACKGROUND DATA: This case represents the most delayed onset of symptoms from a posttraumatic syrinx reported in the literature. Although lysis of arachnoid adhesions and expansile duraplasty to recreate the subarachnoid space have been described for nonshuntable syrinxes, this form of management was used as the primary management modality in this case. METHODS: A posttraumatic syrinx was managed by lysis of the arachnoid adhesions, fenestration of the cyst, and an expansile duraplasty. RESULTS: After surgery, the patient's symptoms improved, and magnetic resonance imaging showed a decrease in the size of the syrinx. CONCLUSION: Posttraumatic syringomyelia represents one of the few surgically remediable presentations of spinal cord injury. Consequently, it is necessary to continuously develop and monitor new management options for this disease. In the case reported here, the syrinx was treated successfully without the implanting a drainage tube.
STUDY DESIGN: A patient in whom posttraumatic syringomyelia developed 34 years after an L2 fracture is reported. OBJECTIVES: To review the pathophysiology and current management modalities for posttraumatic syringomyelia. The delayed presentation and management rationale of this case are emphasized. SUMMARY OF BACKGROUND DATA: This case represents the most delayed onset of symptoms from a posttraumatic syrinx reported in the literature. Although lysis of arachnoid adhesions and expansile duraplasty to recreate the subarachnoid space have been described for nonshuntable syrinxes, this form of management was used as the primary management modality in this case. METHODS: A posttraumatic syrinx was managed by lysis of the arachnoid adhesions, fenestration of the cyst, and an expansile duraplasty. RESULTS: After surgery, the patient's symptoms improved, and magnetic resonance imaging showed a decrease in the size of the syrinx. CONCLUSION:Posttraumatic syringomyelia represents one of the few surgically remediable presentations of spinal cord injury. Consequently, it is necessary to continuously develop and monitor new management options for this disease. In the case reported here, the syrinx was treated successfully without the implanting a drainage tube.
Authors: John D Heiss; Kendall Snyder; Matthew M Peterson; Nicholas J Patronas; John A Butman; René K Smith; Hetty L Devroom; Charles A Sansur; Eric Eskioglu; William A Kammerer; Edward H Oldfield Journal: J Neurosurg Spine Date: 2012-09-07