• Journal of Korean Neurosurgical Society
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• 제29권2호
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• pp.274-279
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• 2000

A 35-year-old female patient who had been paraplegic since her upper thoracic cord injury one and a half years before was presented with a syringomyelia involving C7 to T2 cord segments on follow-up magnetic resonance imaging(MRI). Her pain on the chest and bilateral axilla worsened since about 2 years after initial injury, and MRI demonstrated a progressively enlarging cystic syrinx cavity of the cervicothoracic cord. The posttraumatic syringomyelia was managed operatively by lysis of the arachnoid adhesions, myelotomy, and expansile duraplasty. Post-operatively her pain was relieved, and MRI showed decrease in size of the syrinx, and digital infrared thermographic imaging(DITI) showed diminution of the hyperthermic area on the anterior chest. In conclusion, the posttraumatic syringomyelia can be managed successfully without shunt operation. It seems apparent that expansile duraplasty is effective in controlling the posttraumatic syrinx.

• The Korean Journal of Pain
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• 제21권3호
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• pp.248-251
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• 2008

The clinical syndrome of posttraumatic syringomyelia can complicate major spinal trauma and develops many months after spinal injury. The 50-90% of patients experienced the pain and especially the component of central pain. In patients with central pain following spinal cord injury, ketamine has been shown to be an effective analgesic. We report a case of posttraumatic syringomyelia in a 30-year-old woman who complained of central pain, weakness of both legs and dysesthesia. She had not responded to pulsed radiofrequency, or lidocaine infusion therapy, but a continuous intravenous infusion of ketamine, an N-methyl-D-asparate receptor antagonist, reduced her severe central pain. In conclusion, a ketamine infusion therapy resulted in a significant reduction of central pain without decreasing of motor power and function.

• Journal of Korean Neurosurgical Society
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• 제29권2호
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• pp.255-260
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• 2000

The authors report a posttraumatic syringomyelia in a 30-year-old man who has complained pain, weakness of upper arm and dissociation sensory loss since 2 months before. He was underwent by decompressive laminectomy from T12 to L1, reduction of encroached bony fragments, transpedicular screw fixation from T12 to L2 and posterolateral bony fusion due to burst fracture of L1 at other hospital 3 years ago. Preoperative spinal MRI was highly suggestive of wide-spread, multiseptated syringomyelia from C3 to thoracolumbar junction. We performed wide decompressive laminectomy from T10 to L2 and subarachnoid space reconstrucion composed of microdissection of meningeal fibrosis widely, iatrogenic meningocele formation with lefting the dura mater opened for treatment of spinal-spinal pressure dissociation. Clinical manifestations and radiological findings of the patient were improved after the operation. This technique was thought to be superior to shunting procedures in cases of wide-spread, multiseptated post-traumatic syringomyelia.

• Journal of Korean Neurosurgical Society
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• 제47권3호
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• pp.228-231
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• 2010

Posttraumatic syringomyelia may result from a variety of inherent conditions and traumatic events, or from some combination of these. Many hypotheses have arisen to explain this complex disorder, but no consensus has emerged. A 28-year-old man presented with progressive lower extremity weakness, spasticity, and decreased sensation below the T4 dermatome five years after an initial trauma. Magnetic resonance imaging (MRI) revealed a large, multi-septate syrinx cavity extending from C5 to L1, with a retropulsed bony fragment of L2. We performed an L2 corpectomy, L1-L3 interbody fusion using a mesh cage and screw fixation, and a wide decompression and release of the ventral portion of the spinal cord with an operating microscope. The patient showed complete resolution of his neurological symptoms, including the bilateral leg weakness and dysesthesia. Postoperative MRI confirmed the collapse of the syrinx and restoration of subarachnoid cerebrospinal fluid (CSF) flow. These findings indicate a good correlation between syrinx collapse and symptomatic improvement. This case showed that syringomyelia may develop through obstruction of the subarachnoid CSF space by a bony fracture and kyphotic deformity. Ventral decompression of the obstructed subarachnoid space, with restoration of spinal alignment, effectively treated the spinal canal encroachment and post-traumatic syringomyelia.

• Journal of Korean Neurosurgical Society
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• 제30권5호
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• pp.633-637
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• 2001

The authors report a case of syringo-pleural shunt for recurrent distal obstruction of syringosubarachnoid shunt in a 23-year-old woman. She complained of tingling sensation and dysesthesia on the left upper extremity. Neuroradiologic imaging studies revealed syringomyelia in the left lateral side of the cord from medulla to 7th thoracic cord level. We identified intraoperatively high internal pressure of the syrinx cavity due to distal shunt tube obstruction. Syringo-pleural shunt was performed and cavity size was markedly decreased at later follow up MRI. In conclusion, the posttraumatic syrinx, especially in cases with previous syringosubarachnoid shunt or diffuse subarachnoid scarring, can be successfully managed with syringo-pleural shunt.

• Journal of Korean Neurosurgical Society
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• 제29권10호
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• pp.1389-1395
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• 2000

A case report of a post-traumatic syringomyelia in a 29-year old male, developed 15 years after an L1 burst fracture, is presented. On preoperative MRI, the syrinx extended cephalad above the fracture site through the whole thoracic and cervical cord. Serial myelo-CT was performed to evaluate the dynamics of CSF. It was managed by lysis of the arachnoid adhesions, syringosubarachnoid shunt, and expansile duraplasty. After surgery, the patient's symptoms improved, and marked decrease of the syrinx was seen on postoperative MRI. The pathophysiology, the role of preoperative diagnostic methods especially serial myelo-CT, and the contmporary management modalities for posttraumatic syringomyelia is reviewed along with the pertinent literature.