A critical appraisal of syrinx cavity shunting procedures

J Neurosurg. 1998 Sep;89(3):382-8. doi: 10.3171/jns.1998.89.3.0382.


Object: This study was conducted to evaluate the results of shunting procedures for syringomyelia.

Methods: In a follow-up analysis of 42 patients in whom shunts were placed in syringomyelic cavities, the authors have demonstrated that 21 (50%) developed recurrent cyst expansion indicative of shunt failure. Problems were encountered in patients with syringomyelia resulting from hindbrain herniation, spinal trauma, or inflammatory processes. A low-pressure cerebrospinal fluid state occurred in two of 18 patients; infection was also rare (one of 18 patients), but both are potentially devastating complications of shunt procedures. Shunt obstruction, the most common problem, was encountered in 18 patients; spinal cord tethering, seen in three cases, may account for situations in which the patient gradually deteriorated neurologically, despite a functioning shunt.

Conclusions: Placement of all types of shunts (subarachnoid, syringoperitoneal, and syringopleural) may be followed by significant morbidity requiring one or more additional surgical procedures.

MeSH terms

  • Cerebrospinal Fluid Pressure / physiology
  • Cerebrospinal Fluid Shunts* / adverse effects
  • Cerebrospinal Fluid Shunts* / instrumentation
  • Cerebrospinal Fluid Shunts* / methods
  • Encephalocele / complications
  • Equipment Failure
  • Evaluation Studies as Topic
  • Fistula / etiology
  • Fistula / surgery*
  • Follow-Up Studies
  • Humans
  • Meningitis / complications
  • Recurrence
  • Reoperation
  • Rhombencephalon / pathology
  • Spinal Cord / pathology
  • Spinal Cord Diseases / etiology
  • Spinal Cord Diseases / pathology
  • Spinal Cord Diseases / surgery*
  • Spinal Injuries / complications
  • Syringomyelia / etiology
  • Syringomyelia / surgery*
  • Treatment Outcome