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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
1997-2-13
pubmed:abstractText
The authors conducted a retrospective study of 107 patients treated for syringomyelia associated with arachnoid scarring between 1976 and 1995 at the Departments of Neurosurgery at the Nordstadt Hospital in Hannover, Germany, and the University of California in Los Angeles, California. Twenty-nine patients have not been surgically treated to date because of their stable neurological status. Seventy-eight patients with progressive neurological deficits underwent a total of 121 surgical procedures and were followed for a mean period of 32 (+/- 37) months. All patients demonstrated arachnoid scarring at a level close to the syrinx. In 52 patients the arachnoid scarring was related to spinal trauma, whereas 55 had no history of trauma and developed arachnoid scarring was a result of an inflammatory reaction. Of these, 15 patients had undergone intradural surgery, eight had suffered from spinal meningitis, three had undergone peridural anesthesia, and one each presented with a history of osteomyelitis, spondylodiscitis, and subarachnoid hemorrhage. No obvious cause for the inflammatory reaction resulting in arachnoid scarring could be ascertained for the remaining 26 patients. The postoperative neurological outcome correlated with the severity of arachnoid pathology and the type of surgery performed. Shunting of the syrinx to the subarachnoid, pleural, or peritoneal cavity was associated with recurrence rates of 92% and 100% for focal and extensive scarring, respectively. Successful long-term management of the syrinx required microsurgical dissection of the arachnoid scar and decompression of the subarachnoid space with a fascia lata graft. This operation stabilized the preoperative progressive neurological course in 83% of patients with a focal arachnoid scar. For patients with extensive arachnoid scarring over multiple spinal levels or after previous surgery, clinical stabilization was achieved in only 17% with this technique.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:status
MEDLINE
pubmed:month
Feb
pubmed:issn
0022-3085
pubmed:author
pubmed:issnType
Print
pubmed:volume
86
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
233-40
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:9010425-Adult, pubmed-meshheading:9010425-Aged, pubmed-meshheading:9010425-Arachnoid, pubmed-meshheading:9010425-Arachnoiditis, pubmed-meshheading:9010425-Cicatrix, pubmed-meshheading:9010425-Female, pubmed-meshheading:9010425-Follow-Up Studies, pubmed-meshheading:9010425-Humans, pubmed-meshheading:9010425-Magnetic Resonance Imaging, pubmed-meshheading:9010425-Male, pubmed-meshheading:9010425-Middle Aged, pubmed-meshheading:9010425-Postoperative Complications, pubmed-meshheading:9010425-Recurrence, pubmed-meshheading:9010425-Regression Analysis, pubmed-meshheading:9010425-Retrospective Studies, pubmed-meshheading:9010425-Spinal Cord Injuries, pubmed-meshheading:9010425-Syringomyelia, pubmed-meshheading:9010425-Tomography, X-Ray Computed, pubmed-meshheading:9010425-Treatment Outcome
pubmed:year
1997
pubmed:articleTitle
Treatment of syringomyelia associated with arachnoid scarring caused by arachnoiditis or trauma.
pubmed:affiliation
Medical School of Hannover, Nordstadt Hospital, Germany.
pubmed:publicationType
Journal Article