OBLITERATION OF A POSTTRAUMATIC SPINAL-CORD CYST WITH SOLID HUMAN EMBRYONIC SPINAL-CORD GRAFTS - FIRST CLINICAL ATTEMPT

Cystic lesions of the spinal cord (syringomyelia) may occur after spin al cord injury, Posttraumatic syringomyelia may result in a myelopathy causing symptoms of sensory and motor loss, as well as worsening spas ticity, pain, hyperhidrosis, and autonomic dysreflexia, Shunting of th e cyst cavity along with untethering of the scarred spinal cord is wid ely accepted as the treatment of choice, However, the long-term stabil ization of the progressive myelopathy caused by a posttraumatic cyst i s suboptimal because of arachnoidal rescarring, shunt tube blockage, a nd cyst reexpansion, A new neurosurgical strategy to overcome the comp lication of cyst reexpansion was designed, Experimental studies have s hown the successful use of embryonic spinal cord grafts, including hum an grafts, to obliterate induced spinal cord cavities in rats, The aut hors report the first use of solid human embryonic spinal cord grafts to successfully obliterate 6 cm of a large cyst cavity in a patient be coming myelopathic from a posttraumatic cyst, The grafts are well visu alized by MRI to the 7-month postoperative follow-up and cyst oblitera tion is seen in the region where the grafts were placed.