CT-GUIDED PERCUTANEOUS DRAINAGE OF SYRINGOMYELIA

Purpose: Our purpose is to describe CT-guided percutaneous drainage of syringomyelia as a possible contribution in patient management. Metho d: CT-guided percutaneous drainage was performed on three patients wit h symptomatic syringomyelia. We determined the success of percutaneous decompression by subsequent CT and MRT. The effect of syringomyelia d ecompression in relation to the patient's symptoms was determined. Thi s information was then used to help guide clinical management. Results : In Case 1, percutaneous drainage of a large syrinx in a C5 quadriple gic patient with increasing lower extremity spasticity demonstrated si gnificant decompression by imaging but did not result in clinical impr ovement. A surgical procedure to decompress the syrinx was not perform ed on the basis of this information. In Case 2, percutaneous drainage of a large syrinx in a quadriplegic patient with increasing upper extr emity numbness and weakness demonstrated significant decompression by imaging and resulted in sustained clinical improvement, temporarily ob viating the need for surgery. In Case 3, percutaneous drainage of the rostral aspect of a septated syrinx cavity in a patient with a Chiari I malformation and a syringoperitoneal shunt in place resulted in deco mpression by imaging but failed to relieve the patient's newly develop ed symptoms. An additional shunt was therefore not placed. In no case did the patient experience periprocedural complications or worsening o f symptoms. Conclusion: CT-guided percutaneous drainage of syringomyel ia is a safe and successful technique. It can be used diagnostically t o identify patients that may or may not benefit from surgical syrinx d ecompression and in some cases may provide a temporary therapeutic alt ernative to surgery.