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胸池分流术治疗难治性脊髓空洞症：我的经验。

Syringopleural shunt for refractory syringomyelia: how I do it.

机构信息

Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), Pisa, Italy.

Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Via Paradisa 2, 56100, Pisa, Italy.

出版信息

Acta Neurochir (Wien). 2023 Oct;165(10):3039-3043. doi: 10.1007/s00701-023-05654-y. Epub 2023 Jun 19.

DOI:10.1007/s00701-023-05654-y
PMID:37336834
Abstract

BACKGROUND

Surgical treatment of syringomyelia is directed at the reconstruction of the subarachnoid space and restoration normal cerebrospinal fluid flow. Direct intervention on the syrinx is a rescue procedure and should be offered to patients with refractory syringomyelia.

METHODS

We provide an overview on indications and technique of syringopleural shunt (SPS). The procedure involves the connection of syrinx with the pleural space using a lumboperitoneal shunt. The occurrence of a negative pressure inside the pleural compartment offers an appropriate gradient for drainage from the syrinx.

CONCLUSIONS

The SPS allows for a safe and effective treatment of persistent syringomyelia when management of the underlying cause does not yield substantial improvement.

摘要

背景

脊髓空洞症的手术治疗旨在重建蛛网膜下腔并恢复正常的脑脊液流动。对空洞的直接干预是一种抢救措施，应提供给难治性脊髓空洞症患者。

方法

我们提供了脊髓-胸腔分流术（SPS）的适应证和技术概述。该手术通过腰腹腔分流将空洞与胸腔连接起来。胸腔内产生负压为空洞引流提供了适当的梯度。

结论

当根本原因的治疗不能显著改善时，SPS 可安全有效地治疗持续性脊髓空洞症。

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Syrinx shunts for syringomyelia: a systematic review and meta-analysis of syringosubarachnoid, syringoperitoneal, and syringopleural shunting.脊髓空洞-脑脊髓液分流术治疗脊髓空洞症：脊髓空洞-蛛网膜下腔、脊髓空洞-腹腔和脊髓空洞-胸腔分流术的系统评价和荟萃分析。
J Neurosurg Spine. 2021 Jul 30;35(4):535-545. doi: 10.3171/2020.12.SPINE201826. Print 2021 Oct 1.
2
Diagnosis and treatment of Chiari malformation and syringomyelia in adults: international consensus document.成人 Chiari 畸形和脊髓空洞症的诊断和治疗：国际共识文件。
Neurol Sci. 2022 Feb;43(2):1327-1342. doi: 10.1007/s10072-021-05347-3. Epub 2021 Jun 15.
3
Radiological outcome after surgical treatment of syringomyelia-Chiari I complex in adults: a systematic review and meta-analysis.
成人脊髓空洞症- Chiari I型复合体手术治疗后的放射学结果：一项系统评价和荟萃分析
Neurosurg Rev. 2021 Feb;44(1):177-187. doi: 10.1007/s10143-020-01239-w. Epub 2020 Jan 17.
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Treatment of selected syringomyelias with syringo-pleural shunt: the experience with a consecutive 26 cases.采用脊髓空洞-胸膜分流术治疗特定类型脊髓空洞症：26例连续病例的经验
Clin Neurol Neurosurg. 2015 Oct;137:50-6. doi: 10.1016/j.clineuro.2015.06.012. Epub 2015 Jun 22.
5
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Neurosurgery. 2009 Sep;65(3):471-6; discussion 476. doi: 10.1227/01.NEU.0000350871.47574.DE.
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Transoral approach and its superior extensions to the craniovertebral junction malformations: surgical strategies and results.经口入路及其在颅颈交界区畸形中的优越延伸：手术策略和结果。
Neurosurgery. 2009 May;64(5 Suppl 2):331-42; discussion 342. doi: 10.1227/01.NEU.0000334430.25626.DC.
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