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Surgical Procedure And Future Treatment Options For Posttraumatic Syringomyelia : A Systematic Review Ananda, Sigit; Iskandar; Hamzah, Zaini
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 4 No. 2 (2022): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v4i2.8855

Abstract

Objectives To find the most effective surgical procedure for posttraumatic syringomyelia (PTS) in the last 1 decade. And to look for the latest therapeutic strategies that have the opportunity to be developed in the future. Background Syringomyelia related trauma is uncommon case compared to other etiology such as Chiari Malformation type 1. The management of PTS is remain unclear and debatable. The aim of this study is to review PTS regarding surgical procedure, outcomes, and potential future treatment strategies. Methods This study uses a structured analyses focused on preferred reporting items for systematic review and meta-analyzes (PRISMA). Document selection using the keywords “Postraumatic Syringomyelia” AND “Syringomyelia” and based on publication (10 years). We selected based on the 2020 PRISMA checklist and based on inclusion and exclusion criteria. A total 17 studies met the eligibility criteria. We recorded treatment strategies, level of syrinx, severity of injury, injury to symptom duration and outcomes. Results A total 264 participants with PTS from 15 observational studies and 2 clinical trials were reviewed. We recorded 68% of participants were treated surgically (n=181). The most common procedure is arachnoid lysis and duraplasty (32,5%, n= 59) followed by syrinx shunting (15,4%, n=28) and subarachnoid-subarachnoid bypass (11%, n=20). We found that the syrinx shunting was the most successful procedure with symptoms improved in 82% of patients postoperatively. Overall, symptoms improved in 60% participants who underwent surgery (n=110). We also found deterioration from surgical procedure in 18% participants (n=32). Beside of surgical strategy we also found another therapeutic option that use mesenchymal stromal cells (MSCs) that injected into the syrinx. We recorded a 100% success rate from this procedure (n=7) Conclusion Although the overall outcomes of the surgical procedure for PTS are still unsatisfactory, the syrinx shunting procedure seems to be considered as the most effective surgical procedure. Other therapeutic strategies such as MSCs is considered promising but still require further researches with larger sample sizes. Keywords : syringomyelia, syrinx shunting, trauma
Surgical Outcomes in Primary Benign Extradural Tumors of The Cervical Spine : A Case Report Musfirah, Nurul; Iskandar; Ananda, Sigit
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 5 No. 2 (2023): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v5i2.12588

Abstract

Introduction: The prevalence of spinal tumors is rare, only about 15% of all cases of central nervous system tumors and 90% of cases occur at the age of >20 years, which is a productive age for a person. Case Report: A young 25-year-old woman came to the polyclinic complaining of weakness of both hands and feet (all limbs). The MRI results show a suspected of a space occupying lesion of the extradural spinal cord. The patient then underwent tumor removal laminectomy surgery with a posterior approach. After the operation, his motoric was improving and increased to 4/4. After three months she was able to walk and perform daily activities. Discussion: In younger patients, the tumor diagnosis may be more catastrophic, and the required treatment can have a severe impact on the patient's health-related quality of life. The patient was also very fast and assisted with early ambulation. This can be related to the progressivity of tumor cells, in this case a benign tumor with a border that is not aggressive in invading the surrounding tissue. Conclussion: Early diagnostic and complete surgical resection before the occurrence of severe symptoms will show an excellent prognosis in benign primary extradural tumor. Multidisciplinary surgical planning should therefore also include the histological grade, stage, and extent of the tumor to establish the objective biological aggressiveness of the overlying tumor and in turn estimate the feasibility of resection Keywords: Benign; Primary extradural tumor; Surgical outcome