Work

Treatment of Terminal Syrinx With a Syringo-Subarachnoid Shunt and the Novel Use of a Titanium Knot Fastener: A Case Report

Year: 2024

Type: article

Abstract: A syrinx involves cystic dilation of the central canal of the spinal cord due to the accumulation of cerebrospinal fluid and often results in a neurological deficit. While treatment options vary, surgical management is often utilized and requires an open durotomy. A 70-year-old female presented with one year of progressive low back pain with associated leg numbness, urinary incontinence, bilateral foot drop, and imbalance resulting in multiple falls. MRI revealed a terminal syrinx at the level of the conus medullaris. She underwent an uncomplicated T12-L1 laminectomy for syrinx fenestration and syringo-subarachnoid shunt placement, resulting in improved bladder/bowel function, strength, sensation, and ambulation. The necessary midline durotomy was closed with a running 6-0 prolene suture fastened at the start and end of the suture line with the novel use of the COR-KNOT MICROTM device (LSI Solutions, Victor, New York, US). We present the successful surgical management of a progressively symptomatic terminal syrinx using a syringo-subarachnoid shunt and the novel use of the COR-KNOT MICROTM titanium fastener device for dural closure. Earlier shunting should be considered in the disease course of terminal syrinx, and the successful novel use of a titanium fastener on the dura warrants further investigation.

Source: Cureus

DOI: 10.7759/cureus.73440

Authors: Taylor Furst, Jayden Allegakoen, Muhammad I Jalal, Rohin Singh, Jonathan J Stone

Institution: University of Rochester Medicine

Language: English

Topic: Spinal Dysraphism and Malformations

Subfield: Public Health, Environmental and Occupational Health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4404243351