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KMID : 1040920210060020115
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Journal of Minimally Invasive Spine Surgery and Technique
2021 Volume.6 No. 2 p.115 ~ p.121
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Syringopleural Shunt Insertion Using a Minimally Invasive Approach: Technical Note, Case Series, and Review of the Literature
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Yang Kaiyun
Ellenbogen Yosef
Bhatt Chirayu
Aljoghaiman Majid
Zagzoog Nirmeen
Reddy Kesava
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Abstract
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Objective: Syringomyelia is a rare neurosurgical condition that could benefit from insertion of a syringopleural shunt in selected symptomatic cases. Treatment of syringomyelia through minimally invasive intervention is an attractive alternative to open approach. The objective of this report is to demonstrate the technical aspect, assess the feasibility, outcomes, and complications of syringopleural shunt insertion through minimally invasive surgical (MIS) approach.
Methods: Single-center retrospective chart review was done on patients with syringomyelia who underwent insertion of syringopleural shunts using the Metrx QuadrantTM retractor system from January 1, 2008 to April 1, 2020. A technical report of the steps of the surgical intervention is also described.
Results: Ten procedures were performed on 9 patients with a mean follow-up of 7.2 years. The etiologies of syringomyelia included post-traumatic, Chiari malformation, idiopathic, and diastematomyelia. All patients underwent correction of underlying etiologies prior to insertion of syringopleural shunts. Six patients (67%) had sustained neurological improvement, and 3 (33%) had halted progression of myelopathy. One patient was admitted for urgent removal of newly inserted syringopleural shunt due to immediate postoperative neurological decline and subsequently returned to their neurological baseline. The remaining eight patients were discharged on the same day of surgery.
Conclusion: Minimally invasive techniques have not been widely utilized in the treatment of syringomyelia. Our case series presents a novel, minimally invasive technique for the insertion of a syringopleural shunt, with reduced hospital stay and durable outcomes. Further, our series demonstrates that this technique is feasible and safe in appropriately selected patients.
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KEYWORD
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Syringomyelia, Ventriculo-peritoneal shunt, Minimally invasive surgery
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