ESTABLISHMENT OF A FREE CEREBROSPINAL-FLU ID PASSAGE FOR THE SURGICAL-TREATMENT OF SYRINGOMYELIA

In a cooperative study between the Departments of Neurosurgery at the University of California in Los Angeles, USA, and the Nordstadt Hospit al in Hannover, Germany, the clinical course of 171 patients with syri ngomeylia was documented retrospectively and prospectively. They under went a total of 206 surgical procedures. Excluded from analysis were p atients with syringomyelia due to tumours of the spinal canal. Only pa tients with a progressive clinical course were operated on. Every pati ent with syringomyelia demonstrated some form of cerebrospinal fluid f low disturbance adjacent to the syrinx. Analysis of surgical results r evealed that syrinx shunting procedures provided only temporary improv ement or stabilization of symptoms. On a long-term basis shunting proc edures were successful in only a few cases. Significantly better resul ts were obtained with procedures intended to establish a free passage of cerebrospinal fluid flow throughout the spinal canal. These observa tions led to a pathophysiological hypothesis for the development of sy ringomyelia and to a new concept for the surgical treatment of this di sorder.