Operative treatment of syringomyelia

There are many methods applied in operative treatment of syringomyelia. They may be divided into three groups: suboccipital decompression, myelotomy with drainage of the syringomyelic cavity, and terminal ventriculostomy. Occipito-vertebral decompression is the treatment of choice in cases of coexisting abnormalities in the region of the occipital foramen. It is also used in cases of syringomyelia without these anomalies. Multiplicity of proposed operative techniques concerns the depth of penetration in the posterior cavity, the width of bony opening and kind of material used for the duroplasty. Myelotomy with syringomyelic cavity drainage is recommended in cases of syringomyelia caused by local traumatic or inflammatory injury of the spine. It is also applied as a supplementary procedure in cases of unsuccessful occipito-vertebral decompression. Terminal ventriculostomy may be recommended in cases of anchoring of the spine and in cases of cavities located in lower parts of the spine and descending to the filum terminale.