Zhongguo linchuang yanjiu (May 2024)

Trans-segmental shunt surgery for the treatment of syringomeylia resulting from trauma and infection

  • XU Chi, YANG Jichao, JI Shanfeng, GU Haoyuan, LI Yulong, LOU Yongli

DOI
https://doi.org/10.13429/j.cnki.cjcr.2024.05.011
Journal volume & issue
Vol. 37, no. 5
pp. 703 – 708

Abstract

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Objective To investigate the clinical effect of transsegmental shunt surgery in the treatment of syringomyelia due to trauma and infection in perspective of cerebrospinal fluid dynamics. Methods A total of 17 syringomyelia patients admitted to the Syringomyelia Department in Zhengzhou Central Hospital from July 2019 to June 2021 were collected, all patients underwent trans-segmental shunt surgery for syringomyelia. The clinical features, electromyography and imaging features of patients before and after operation were analyzed. The Chicago Chiari outcome scale (CCOS) and Japanese Orthopaedic Association (JOA) score improvement index were used to evaluate the clinical prognosis of patients. Pearson method was used to analyze the correlation between the JOA score improvement index, CCOS score and the difference of peak velocity of cerebrospinal fluid. Results After transsegmental shunt, the clinical symptoms of 14 cases were significantly improved, and 3 cases did not improve. The JOA score was significantly higher after surgery than before surgery (17.65±1.80 vs 8.94±2.36, t=11.609, P＜0.01). Limb numbness, dissociative sensory disorder, gait disorder, dizziness, lower limb weakness, ataxia, sensory nerve conduction, motor nerve conduction, maximum diameter of cavity and peak cerebrospinal fluid flow in the foramen magnum and the midbrain aquaquet during systolic and diastolic periods were significantly improved after surgery (P＜0.05). JOA score improvement index and CCOS score were significantly correlated with the difference of cerebrospinal fluid peak velocity (P＜0.05). Conclusion For patients with syringomyelia caused by trauma or infection, trans-segmental shunt of syringomyelia can improve the cerebrospinal fluid dynamics of patients with syringomyelia to a certain extent, promote the reduction of syringomyelia and improve the clinical symptoms of patients.

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