Abstract:
:Syrinx can be secondary to many etiologies, including tumor, Chiari malformation, tethered cord, or sequelae of infection or trauma. Posttraumatic syringomyelia, a potential complication of spinal injury, can insidiously present years after the initial event. Expansion of the cerebrospinal fluid-filled cyst can lead to pain, sensorimotor deficits, and myelopathy. Simple fenestration is often unsuccessful, therefore permanent shunting of cerebrospinal fluid from the syrinx to the subarachnoid, pleura, or peritoneum can prevent recurrence. In this report, we present a patient with a complex L3 burst fracture from a remote trauma s/p stabilization. Thirty-two years later, he developed progressive neck pain, upper extremity radiculopathy, dysesthesias, and clinical myelopathy (dropping objects, gait imbalance). An MRI demonstrated an expansile syrinx from C2-conus medullaris which previously had been unsuccessfully treated by fenestration. We offered a T1-2 laminectomy and placement of synringosubarachnoid shunt. In the associated video (Supplemental Digital Content 1, http://links.lww.com/CLINSPINE/A107), we demonstrate the step-by-step approach for this procedure, including microsurgical intradural intramedullary exploration and insertion of a T-tube shunt catheter. We additionally demonstrate nuances of ultrasonography that guide medullary entry localization and confirmation of successful shunt placement. Finally, we review preoperative planning pearls pertinent to revision surgeries, pitfalls of the operation, and postoperative management strategies germane to successful outcomes.
journal_name
Clin Spine Surgjournal_title
Clinical spine surgeryauthors
Hussain I,Greenfield JPdoi
10.1097/BSD.0000000000000835subject
Has Abstractpub_date
2020-06-01 00:00:00pages
185-191issue
5eissn
2380-0186issn
2380-0194journal_volume
33pub_type
杂志文章abstract:OBJECTIVE:To provide reasoning and steps for the placement of sacral alar-iliac (S2AI) screws for pelvic arthrodesis to aid osseous lumbosacral fusion. SUMMARY OF BACKGROUND DATA:Studies support lower rates of screw breakage and need for revision surgery or hardware removal for S2AI screws compared with traditional il...
journal_title:Clinical spine surgery
pub_type: 杂志文章
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abstract:STUDY DESIGN:This was a cross-sectional cohort study. OBJECTIVE:The objective of this study was to identify the prevalence of sleep disturbance in patients with symptomatic lumbar spinal stenosis (LSS) and to establish the relationship between sleep disturbance and both functional disability and health-related quality...
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journal_title:Clinical spine surgery
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abstract:STUDY DESIGN:This is a retrospective, self-controlled cohort study, at a single center. OBJECTIVE:The aim of this study was to evaluate the long-term outcome of sexual function after surgical treatment of single-level lumbar disk herniation (LDH). SUMMARY OF BACKGROUND DATA:The impact of surgical treatment on sexual ...
journal_title:Clinical spine surgery
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doi:10.1097/BSD.0000000000000669
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journal_title:Clinical spine surgery
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journal_title:Clinical spine surgery
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doi:10.1097/BSD.0000000000000174
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000375
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journal_title:Clinical spine surgery
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journal_title:Clinical spine surgery
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doi:10.1097/BSD.0000000000000047
更新日期:2017-04-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000370
更新日期:2016-04-01 00:00:00
abstract:PURPOSE:A retro-odontoid pseudotumor that is not associated with rheumatoid arthritis or hemodialysis is clinically rare. The majority of surgeons select transoral resection as the surgical treatment, often followed by posterior fusion or posterior decompression and fusion. In contrast, some authors have reported succe...
journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0b013e31829eb7e6
更新日期:2016-12-01 00:00:00
abstract:STUDY DESIGN:A method for measuring occipitocervical angle. OBJECTIVE:To develop a new method of measurement for assessing the occipitocervical angle using intraoperative fluoroscopic imaging, and to examine its reliability. SUMMARY OF BACKGROUND DATA:To avoid postoperative complications following occipitocervical fu...
journal_title:Clinical spine surgery
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doi:10.1097/BSD.0000000000000478
更新日期:2017-08-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000001076
更新日期:2020-09-25 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000529
更新日期:2017-04-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章,评审
doi:10.1097/BSD.0000000000000841
更新日期:2019-08-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000797
更新日期:2019-06-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章,评审
doi:10.1097/BSD.0000000000000593
更新日期:2018-03-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000794
更新日期:2019-08-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
doi:10.1097/BSD.0000000000000461
更新日期:2017-03-01 00:00:00
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journal_title:Clinical spine surgery
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doi:10.1097/BSD.0000000000001001
更新日期:2020-12-01 00:00:00
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journal_title:Clinical spine surgery
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doi:10.1097/BSD.0000000000001106
更新日期:2020-12-08 00:00:00
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journal_title:Clinical spine surgery
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更新日期:2018-07-01 00:00:00
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journal_title:Clinical spine surgery
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更新日期:2018-03-01 00:00:00
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journal_title:Clinical spine surgery
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更新日期:2017-11-01 00:00:00
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journal_title:Clinical spine surgery
pub_type: 杂志文章
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更新日期:2021-02-01 00:00:00
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journal_title:Clinical spine surgery
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更新日期:2017-07-01 00:00:00
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journal_title:Clinical spine surgery
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journal_title:Clinical spine surgery
pub_type: 杂志文章
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更新日期:2018-06-01 00:00:00
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journal_title:Clinical spine surgery
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doi:10.1097/BSD.0000000000000807
更新日期:2019-06-01 00:00:00