Syringo-Subarachnoid Shunt with Tube Versus T-Tube via the Dorsal Root Entry Zone Approach for Eccentric Syringomyelia

Abstract

OBJECTIVEThe objective of this study was to compare the clinical therapeutic efficacy of syringo-subarachnoid shunt with direct tube and T-tube via the dorsal root entry zone(DREZ) approach for the treatment of eccentric syringomyelia. METHODSA retrospective study was performed on the clinical data of 41 patients associated with idiopathic or secondary eccentric syringomyelia from November 2011 to December 2022. Syringo-subarachnoid shunt with a direct tube or T-tube via the DREZ approach were conducted. The modified Japanese Orthopedic Association (mJOA) low back pain scale was used to investigate the severity of clinical symptoms. MRI was used to investigate therapeutic efficacy（reduction of the cavity volume by over 10% was considered an improvement and 50% was considered a significant improvement）. RESULTSThe incision length of the spinal cortex in the direct tube group was shorter than in the T-tube group (3.10±0.28cm vs. 5.03±0.19cm), with a significant difference between this two groups(t=-52.56, P<0.001). JOA 3 months post-surgery was significantly better than pre-operation JOA both in direct tube group（t=40.954,P<0.001） and in T-tube group（t=24.769,P<0.001）. The statistical comparison revealed there were no difference in image improvement condition between direct tube group and T-tube group 3 months post-surgery( χ2=0.20，p=0.655) and 12 months post-surgery(χ2=0.21，p=0.647). CONCLUSIONSyringo-subarachnoid shunt with direct tube via the DREZ approach for the treatment of eccentric syringomyelia is safer than with T-tube via the DREZ approach due to more minimal incision length and lesser occupying effect with same therapeutic efficacy.