Preparation for Surgery for Syringomyelia in Children

Indications for Procedure

• Symptomatic or radiographic progression: Enlarging syringomyelia with progressive neurological symptoms and signs should be treated. The decision is far more complex when a patient is asymptomatic or when symptoms cannot be clearly attributed to the syrinx. In this case, careful consideration of other options should be taken, including close observation in cases where the syrinx is small and symptoms are not entirely clear.
• Failure in treatment of etiology: Again, the best way to manage syringomyelia is to treat the underlying etiology. Occasionally, direct drainage of the syringomyelia cavity is warranted due to failure of primary treatment or when the syrinx is caused by diffuse arachnoiditis.

Preoperative Orders

• Routine

Anesthetic Considerations

• None

Devices to Be Implanted

• Tubing for shunt: Devices for direct syrinx shunting include simple silastic tubes or small flexible T tubes that are designed specifically for syrinx drainage. These can be directed to the subarachnoid space and anchored or tunneled into the pleural or peritoneal spaces as needed.