Does long segment subarachnoido-subarachnoid shunt prevent posttraumatic and postinfectious spinal arachnoid cyst recurrence?: technical note and case series.

Autor: Akgun MY; Department of Neurosurgery, Koc University Hospital, Istanbul, Turkey; Spine Center, Koc University Hospital, Istanbul, Turkey., Ates O; Department of Neurosurgery, Koc University Hospital, Istanbul, Turkey; Spine Center, Koc University Hospital, Istanbul, Turkey., Akyoldas G; Department of Neurosurgery, Koc University Hospital, Istanbul, Turkey., Tepebasili MA; Department of Neurosurgery, Koc University Hospital, Istanbul, Turkey., Sasani M; Department of Neurosurgery, Koc University Hospital, Istanbul, Turkey; Spine Center, Koc University Hospital, Istanbul, Turkey., Oktenoglu T; Department of Neurosurgery, Koc University Hospital, Istanbul, Turkey; Spine Center, Koc University Hospital, Istanbul, Turkey., Ozer AF; Department of Neurosurgery, Koc University Hospital, Istanbul, Turkey; Spine Center, Koc University Hospital, Istanbul, Turkey; Bioengineering and Orthopaedic Surgery Colleges of Engineering and Medicine, University of Toledo, Toledo, OH, USA. Electronic address: alifahirozer@gmail.com.
Jazyk: angličtina
Zdroj: Neuro-Chirurgie [Neurochirurgie] 2024 Jul; Vol. 70 (4), pp. 101555. Date of Electronic Publication: 2024 Mar 23.
DOI: 10.1016/j.neuchi.2024.101555
Abstrakt: Syringomyelia associated with extensive spinal adhesive arachnoiditis (SAA) can be defined as a rare but progressive disease with potentially devastating clinical consequences. Diagnosis can be challenging due to the absence of specific clinical findings, confusion with other pathologies, and late imaging modalities. The treatment strategy for syringomyelia associated with extensive SAA should include direct drainage of the syringomyelia, and dissection of the adhesive arachnoid with expansive duraplasty. Hence, several approaches have been reported for arachnoid dissection and decompression of the subarachnoid space. The high risk of recurrence after the operation is one of the most challenging situations. First two cases were operated previously, and the cyst walls were removed and anastomosed to the intact subarachnoid space at the upper and lower ends by each other. However, in both cases, the cyst recurred after a short time and they were anastomosed again in our clinic. A subarachnoid-subarachnoid shunt was placed with a multi-hole silicone tube extending to the proximal and distal intact subarachnoid spaces and passing through the cyst removal area. In our third case, the shunt system we described was applied directly, and satisfactory results were obtained in the clinical follow-up of the patient. It has been demonstrated that subarachnoido-subarachnoid shunt is a very satisfactory treatment option for this type of pathology, which is difficult to follow and treat.
(Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
Databáze: MEDLINE
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