Syringomyelia Surgery

The end of the spinal cord is a cystic dilatation of the spinal cord below the waist 3, often coexisting with the recessive spina bifida. Some patients have spinal cord longitudinal fissure, fatty meningocele, appendix sinus, skin or epithelioid cyst, anal malformation, and terminal silk traction tethered syndrome. CT or MRI scans can be used for the diagnosis of this disease, but MRI scans are more desirable. When the cavity is large, there are obvious clinical symptoms, so surgery is needed. Treating diseases: syringomyelia Indication Spinal end cavity surgery is suitable for: End of the spinal cord cavity, can be combined with fatty meningocele, sinus sinus and other lesions. Contraindications Late syringomyelia, severe degeneration of the spinal cord caused by paraplegia, or limb contracture, is generally not suitable for surgery. Preoperative preparation 1. General preparation of the whole body According to the condition and examination, the patient's general condition is actively improved, and various necessary supplements and corrections are given. 2, those with constipation, pre-operative laxatives, enema during the night before surgery. Those with dysuria should be catheterized before surgery and indwelling catheter. 3, postoperative need to prone, should be prone position training in advance, so that patients can adapt to this lying position. 4, sedatives before the operation, phenobarbital 0.1g. 5, fasting within 6 ~ 8h before surgery. 6, the day before surgery to prepare the surgical skin, cleaning shaving, the range should be more than 15cm around the incision. 7. Give medication before anesthesia according to the needs of anesthesia. 8, preoperative positioning should be determined before the scheduled removal of the spine position of the lamina, the easiest way is to locate according to the body surface markers. Due to the difference in body shape, there may be 1 or 2 spinous process errors by marker positioning. In order to avoid the error, it can be positioned according to the body surface marker, and then a type of lead is glued on the body surface of the corresponding spinous process. After taking the X-ray film, the surgical site is verified from the position of the lead on the X-ray film. Surgical procedure 1. Incision In the expected lesion site, the incision line was marked with gentian violet, and a straight incision was made on the spinous process. 2, laminectomy Laminectomy is performed in the lesion area, but the extent of the resection of the lamina depends on the location of the syringomyelia. 3, dural incision Carefully cut the dura mater under the operating microscope to explore the spinal canal. 4, treatment of local lesions Local adhesions in the saphenous spina bifida are separated, the ligaments of the spinal cord and nerve roots are severed, and the thick, tight end filaments are severed, and the spinal cord is retracted significantly. If a lesion such as a skin or epithelioid cyst is combined, it should be removed. 5, cavity shunt A small opening was made along the bulging cavity of the syringomyelia, and a cavity-subarachnoid shunt was performed using a silicone ventricle drainage catheter. 6, repair spina bifida In patients with recessive spina bifida, there are many different degrees of bone defects in the lamina, and the defect can be repaired with autologous bone or bone substitutes. 7, close the incision The dura mater is tightly sutured, followed by suturing the muscle layer, subcutaneous tissue and skin. complication The extent of the hollow incision is too large, which can increase the spinal cord injury and aggravate the neurological symptoms.