Gait, Pain


Unchanged Lost to follow up

Abbreviation: Fenestr. = fenestration

Fig. 3.84. (Continued) g A GoreTex® duraplasty was inserted. h The postoperative T1-weighted MRI demonstrates a good decompression of the cervical cord andafree CSF passage in the operated area. Preoperative symptoms improved

Abbreviation: Fenestr. = fenestration nent clinical problem [99], with four patients developing motor deficits.

According to our experience with syringomyelia, we have been reluctant to place shunts in these cysts. Only one patient underwent cyst shunting to the sub-arachnoid space with a good clinical and radiological result. Whenever the cyst wall had displaced the cord to a degree that only the pia mater covered the cyst lining, wide fenestrations were performed (Fig. 3.83) [99]. In all other instances, we have opened the cyst in the midline and then decompressed the subarachnoid space with a generous dura graft (Figs. 3.82 and 3.84). One recurrence was observed among this latter group with postoperative improvements reported by four patients and unchanged situations by three patients.

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