Syringomyelia: A neurological and surgical spectrum

Francis W. Gamache, Thomas B. Ducker

Research output: Contribution to journalArticle

Abstract

Because of the variation in the natural history, anatomy, surgical treatment, and follow-up periods reported to date, very few firm conclusions can be drawn regarding syringomyelia. With the advent of magnetic resonance scanning, cases of syringomyelia are being detected earlier and a better understanding of the disease has been facilitated. The authors report their personal experiences with 21 patients followed for 5-20 years. No single surgical procedure appears to predictably remedy any syrinx for more than a brief period of several years. Complete collapse of the syrinx does not eradicate all symptoms. Direct treatment of the syrinx makes intuitive sense for those syrinxes that do not communicate with the fourth ventricle. On the other hand, for syrinxes that are likely to communicate with the fourth ventricle, shunting of the ventricular system, particularly where ventriculomegaly exists (i.e., any degree of radiographie evidence of ventricular enlargement), should be considered initially. Procedures such as posterior fossa decompression may be necessary as dictated by the neurological condition of the patient. In the authors' experience, shunting procedures provided better improvement, with longer duration of improvement than with posterior fossa decompression. The timing and surgical details of posterior fossa decompression remain to be elucidated.

Original languageEnglish (US)
Pages (from-to)293-298
Number of pages6
JournalJournal of Spinal Disorders and Techniques
Volume3
Issue number4
StatePublished - 1990

Fingerprint

Syringomyelia
Syringes
Decompression
Fourth Ventricle
Natural History
Anatomy
Magnetic Resonance Spectroscopy
Therapeutics

Keywords

  • Posterior fossa decompression
  • Syringomyelia
  • Syringoperitoneal shunt
  • Syringosubarachnoid shunt
  • Ventriculoperitoneal shunt

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine
  • Surgery

Cite this

Syringomyelia : A neurological and surgical spectrum. / Gamache, Francis W.; Ducker, Thomas B.

In: Journal of Spinal Disorders and Techniques, Vol. 3, No. 4, 1990, p. 293-298.

Research output: Contribution to journalArticle

Gamache, FW & Ducker, TB 1990, 'Syringomyelia: A neurological and surgical spectrum', Journal of Spinal Disorders and Techniques, vol. 3, no. 4, pp. 293-298.
Gamache, Francis W. ; Ducker, Thomas B. / Syringomyelia : A neurological and surgical spectrum. In: Journal of Spinal Disorders and Techniques. 1990 ; Vol. 3, No. 4. pp. 293-298.
@article{917c01f256394180ad8a57454986f8a4,
title = "Syringomyelia: A neurological and surgical spectrum",
abstract = "Because of the variation in the natural history, anatomy, surgical treatment, and follow-up periods reported to date, very few firm conclusions can be drawn regarding syringomyelia. With the advent of magnetic resonance scanning, cases of syringomyelia are being detected earlier and a better understanding of the disease has been facilitated. The authors report their personal experiences with 21 patients followed for 5-20 years. No single surgical procedure appears to predictably remedy any syrinx for more than a brief period of several years. Complete collapse of the syrinx does not eradicate all symptoms. Direct treatment of the syrinx makes intuitive sense for those syrinxes that do not communicate with the fourth ventricle. On the other hand, for syrinxes that are likely to communicate with the fourth ventricle, shunting of the ventricular system, particularly where ventriculomegaly exists (i.e., any degree of radiographie evidence of ventricular enlargement), should be considered initially. Procedures such as posterior fossa decompression may be necessary as dictated by the neurological condition of the patient. In the authors' experience, shunting procedures provided better improvement, with longer duration of improvement than with posterior fossa decompression. The timing and surgical details of posterior fossa decompression remain to be elucidated.",
keywords = "Posterior fossa decompression, Syringomyelia, Syringoperitoneal shunt, Syringosubarachnoid shunt, Ventriculoperitoneal shunt",
author = "Gamache, {Francis W.} and Ducker, {Thomas B.}",
year = "1990",
language = "English (US)",
volume = "3",
pages = "293--298",
journal = "Journal of Spinal Disorders",
issn = "1536-0652",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Syringomyelia

T2 - A neurological and surgical spectrum

AU - Gamache, Francis W.

AU - Ducker, Thomas B.

PY - 1990

Y1 - 1990

N2 - Because of the variation in the natural history, anatomy, surgical treatment, and follow-up periods reported to date, very few firm conclusions can be drawn regarding syringomyelia. With the advent of magnetic resonance scanning, cases of syringomyelia are being detected earlier and a better understanding of the disease has been facilitated. The authors report their personal experiences with 21 patients followed for 5-20 years. No single surgical procedure appears to predictably remedy any syrinx for more than a brief period of several years. Complete collapse of the syrinx does not eradicate all symptoms. Direct treatment of the syrinx makes intuitive sense for those syrinxes that do not communicate with the fourth ventricle. On the other hand, for syrinxes that are likely to communicate with the fourth ventricle, shunting of the ventricular system, particularly where ventriculomegaly exists (i.e., any degree of radiographie evidence of ventricular enlargement), should be considered initially. Procedures such as posterior fossa decompression may be necessary as dictated by the neurological condition of the patient. In the authors' experience, shunting procedures provided better improvement, with longer duration of improvement than with posterior fossa decompression. The timing and surgical details of posterior fossa decompression remain to be elucidated.

AB - Because of the variation in the natural history, anatomy, surgical treatment, and follow-up periods reported to date, very few firm conclusions can be drawn regarding syringomyelia. With the advent of magnetic resonance scanning, cases of syringomyelia are being detected earlier and a better understanding of the disease has been facilitated. The authors report their personal experiences with 21 patients followed for 5-20 years. No single surgical procedure appears to predictably remedy any syrinx for more than a brief period of several years. Complete collapse of the syrinx does not eradicate all symptoms. Direct treatment of the syrinx makes intuitive sense for those syrinxes that do not communicate with the fourth ventricle. On the other hand, for syrinxes that are likely to communicate with the fourth ventricle, shunting of the ventricular system, particularly where ventriculomegaly exists (i.e., any degree of radiographie evidence of ventricular enlargement), should be considered initially. Procedures such as posterior fossa decompression may be necessary as dictated by the neurological condition of the patient. In the authors' experience, shunting procedures provided better improvement, with longer duration of improvement than with posterior fossa decompression. The timing and surgical details of posterior fossa decompression remain to be elucidated.

KW - Posterior fossa decompression

KW - Syringomyelia

KW - Syringoperitoneal shunt

KW - Syringosubarachnoid shunt

KW - Ventriculoperitoneal shunt

UR - http://www.scopus.com/inward/record.url?scp=0025668730&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025668730&partnerID=8YFLogxK

M3 - Article

C2 - 2134442

AN - SCOPUS:0025668730

VL - 3

SP - 293

EP - 298

JO - Journal of Spinal Disorders

JF - Journal of Spinal Disorders

SN - 1536-0652

IS - 4

ER -