• Acta clinica Croatica · Mar 2020

    Case Reports

    MINIMALLY INVASIVE TREATMENT OF IDIOPATHIC SYRINGOMYELIA USING MYRINGOTOMY T-TUBES: A CASE REPORT AND TECHNICAL NOTE.

    • Domagoj Jugović, Roman Bošnjak, Krešimir Rotim, and Günther C Feigl.
    • 1Department of Neurosurgery, Bamberg General Hospital, Bamberg, Germany; 2University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia; 3Department of Neurosurgery, University Medical Centre Ljubljana, Ljubljana, Slovenia; 4Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 5Josip Juraj Strossmayer University of Osijek, Faculty of Medicine, Osijek, Croatia; 6University of Applied Health Sciences, Zagreb, Croatia; 7Department of Neurosurgery, Tübingen University Hospital, Tübingen, Germany; 8Department of Neurological Surgery, Houston Methodist Hospital, Houston, Texas, USA.
    • Acta Clin Croat. 2020 Mar 1; 59 (1): 177-182.

    AbstractSyringomyelia is characterized by a fluid-filled cavity within the spinal cord. Expansion of the syrinx often results in the clinical course of progressive neurologic deficit. Surgery for syringomyelia generally aims to treat the underlying cause, if it is known. However, little is known about idiopathic syringomyelia, which requires specific management. In our paper, an alternative, minimally invasive treatment option for large symptomatic idiopathic cervicothoracic syrinx is described and discussed. We present a case of a 44-year-old male without a history of spinal cord trauma, infection, or other pathologic processes, who presented for thoracic pain. Due to progressive pain and left leg paresis, magnetic resonance imaging (MRI) was performed and revealed extensive septated syringomyelia from T5 to T7 and hydromyelia cranially. We applied minimally invasive technique for shunting the idiopathic syrinx into the subarachnoid space using two Richards modified myringotomy T-tubes. Postoperative MRI revealed significant decrease in the syrinx size and clinical six-month follow-up showed improvement of clinical symptoms. This minimally invasive treatment of syringomyelia was found to be an effective method for idiopathic septated syrinx, without evident underlying cause. However, long-term follow-up and more patients are necessary for definitive evaluation of this technique.

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