A CRITICAL-APPRAISAL OF SYRINX CAVITY SHUNTING PROCEDURES

Object. This study was conducted to evaluate the results of shunting p rocedures for syringomyelia. Methods. In a follow-up analysis of 42 pa tients in whom shunts were placed in syringomyelic cavities, the autho rs have demonstrated that 21 (50%) developed recurrent cyst expansion indicative of shunt failure. Problems were encountered in patients wit h syringomyelia resulting from hindbrain herniation, spinal trauma, or inflammatory processes. A low-pressure cerebrospinal fluid state occu rred in two of 18 patients; infection was also rare (one of 18 patient s), but both are potentially devastating complications of shunt proced ures. Shunt obstruction, the most common problem, was encountered in 1 8 patients: spinal cord tethering, seen in three cases, may account Fo r situations in which the patient gradually deteriorated neurologicall y, despite a functioning shunt. Conclusions. Placement of all types of shunts (subarachnoid, syringoperitoneal, and syringopleural) may be f ollowed by significant morbidity requiring one or more additional surg ical procedures.