Shunting for syringomyelia in patients with spinal cord injuries: Self-reported, long-term effects in 8 patients

Objective: To investigate the long-term effects of shunting on neurologic o utcome of syringomyelia, a complication of spinal cord injury (SCI). Design: Retrospective data collection using telephonic survey. Setting: University based medical center. Participants: Eight of 15 patients who had shunts placed between 1976 and 1 999. Interventions: Review of clinical records and self-reported telephone inter view. Main Outcomes Measures: Initial clinical presentation, recovery after shunt placement. and subsequent neurologic status were recorded. Patients were a sked to rate symptomatic improvement after surgery on a 100-point analog sc ale; they were also asked whether they would have the surgery again. Results: Presenting symptoms were weakness in all 8 patients, pain in 5 pat ients, and numbness in 5 patients. After shunting, 6 patients had improved strength, all had less pain, and 2 had less numbness. Six patients experien ced neurologic decline an average of 2 years after shunt placement, 3 becau se of shunt failure, 2 from a new syrinx, and 1 from both shunt failure and new syrinx. Two of the 3 patients who underwent second shunt placements fo r a new syrinx had full neurologic recovery. Six patients said they would r epeat the shunting procedure if necessary, I was uncertain, and I would not . Conclusion: Initial improvements noted after shunting provide long-lasting effects, even though many patients may need a second procedure. Less pain a nd improved strength are more significant than decreased numbness.