MANAGEMENT OF POSTTRAUMATIC SYRINGOMYELIA USING AN EXPANSILE DURAPLASTY - A CASE-REPORT

Study Design. A patient in whom posttraumatic syringomyelia developed 34 years after an L2 fracture is reported. Objective. To review the pa thophysiology and current management modalities for posttraumatic syri ngomyelia. The delayed presentation and management rationale of this c ase are emphasized. Summary of Background Data. This case represents t he most delayed onset of symptoms from a posttraumatic syrinx reported in the literature. Although lysis of arachnoid adhesions and expansil e duraplasty to recreate the subarachnoid space have been described fo r nonshuntable syrinxes, this form of management was used as the prima ry management modality in this case. Methods. A posttraumatic syrinx w as managed by lysis of the arachnoid adhesions, fenestration of the cy st, and an expansile duraplasty. Results. After surgery, the patient's symptoms improved, and magnetic resonance imaging showed a decrease i n the size of the syrinx. Conclusion. Posttraumatic syringomyelia repr esents one of the few surgically remediable presentations of spinal co rd injury. Consequently, it is necessary to continuously develop and m onitor new management options for this disease. In the case reported h ere, the syrinx was treated successfully without the implanting a drai nage tube.