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The patient came to the clinic 14-May-2006 with LBP and left
sciatica for 2 years with difficulty in walking
with deteriorating course. On examination, he had hypalgesia of
the index finger left hand with weak extension and grip
of the left hand and the triceps of the left upper limb. He had
hypalgesia below D2 with Babinski positive both sides and weak all
muscles both lower limbs.
The patient was sent for MRI and the
MRI cervicodorsal spine, which showed syringomyelia from C4
down to D5 with compression of the spinal cord at the level of C5-6
from behind. The patient
was advised to undergo surgery.
Decompressive laminectomy of C5 down to D1 was performed and the
dura was opened. It seems that, after decompressing the spinal cord
the syrinx diminished in size and the spinal cord regained
acceptable shape.
So as not to be confident and to avoid recurrence of the cyst, at
the DREZ area right side using spinal needle, puncture of the spinal
cord was performed and about 4 cc of CSF was obtained, after what,
the spinal cord collapsed completely.
So as to avoid surgical trauma to the spinal cord part of the
lumboperitoneal shunt was used to insert the tube inside the syrinx
cavity and the subdural space and it was fixed to the arachnoid
membrane. Further 0.5 cc of CSF was obtained from the tube. Routine
closure. |
