Tratamento cirúrgico da siringomielia pela Técnica de Gardner

Almeida, Gilberto M.; Bianco, Eduardo; Shibata, Milton K.; Manreza, Luiz Alcides; Marchese, Antonio J. Tedesco

doi:10.1590/S0004-282X1973000400002

Resumos

O tratamento cirúrgico da siringomielia é, em geral, considerado decepcionante. Vários tipos de drenagem da cavidade siringomiélica não têm fornecido resultados satisfatórios. Gardner, em magnífica série de trabalhos, mostrou que a siringomielia e as várias malformações associadas à hidrocefalia têm fisiopatogenia única. Baseado em sua teoria, Gardner propôs, em 1958, o bloqueio da comunicação entre o IV ventrículo e o canal central da medula, para o tratamento da siringomielia. Esta técnica não tem sido realizada com muita freqüência. Empregamos o método proposto por Gardner em 4 pacientes, os quais melhoraram após a intervenção cirúrgica.

The surgical treatment of syringomyelic patients is usually considered as deceptional. The drainage methods employed have resulted insatisfactory. Gardner, in a classical series of papers, developed the "hydromyelic theory" to explain syringomyelia and others nervous system malformatins. Founded on his own theory he proposed the blockadge of the communication between the fourth ventricle and the central canal. We have employed this method on 4 patients, with satisfactory results.

Tratamento cirúrgico da siringomielia pela Técnica de Gardner

Syringomyelia: its surgical treatment by Gardner's method. Report of four cases

Gilberto M. Almeida^I; Eduardo Bianco^II; Milton K. Shibata^II; Luiz Alcides Manreza^III; Antonio J. Tedesco Marchese^III

^IClínica Neurológica da Faculdade de Medicina da Universidade de São Paulo (Prof. Horacio M. Canelas) e da Clínica Neurocirúrgica do Hospital 9 de Julho (Prof. Gilberto Machado de Almeida): Livre Docente

^IIClínica Neurológica da Faculdade de Medicina da Universidade de São Paulo (Prof. Horacio M. Canelas) e da Clínica Neurocirúrgica do Hospital 9 de Julho (Prof. Gilberto Machado de Almeida): Residentes

^IIIClínica Neurológica da Faculdade de Medicina da Universidade de São Paulo (Prof. Horacio M. Canelas) e da Clínica Neurocirúrgica do Hospital 9 de Julho (Prof. Gilberto Machado de Almeida): Assistentes

RESUMO

O tratamento cirúrgico da siringomielia é, em geral, considerado decepcionante. Vários tipos de drenagem da cavidade siringomiélica não têm fornecido resultados satisfatórios. Gardner, em magnífica série de trabalhos, mostrou que a siringomielia e as várias malformações associadas à hidrocefalia têm fisiopatogenia única. Baseado em sua teoria, Gardner propôs, em 1958, o bloqueio da comunicação entre o IV ventrículo e o canal central da medula, para o tratamento da siringomielia. Esta técnica não tem sido realizada com muita freqüência. Empregamos o método proposto por Gardner em 4 pacientes, os quais melhoraram após a intervenção cirúrgica.

SUMMARY

The surgical treatment of syringomyelic patients is usually considered as deceptional. The drainage methods employed have resulted insatisfactory.

Gardner, in a classical series of papers, developed the "hydromyelic theory" to explain syringomyelia and others nervous system malformatins. Founded on his own theory he proposed the blockadge of the communication between the fourth ventricle and the central canal. We have employed this method on 4 patients, with satisfactory results.

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Clínica Neurológica Faculdade de Medicina da Universidade de São Paulo Caixa Postal 3461 São Paulo, SP Brasil.

1. APPLEBY, A.; BRADLEY, W. G.; FOSTER, J. B.; HANKINSON, J. & HUDGSON, P. Syringomyelia due to chronic arachnoiditis at the foramen magnum J. neurol. Sci. 8:4541, 1969.
2. BENINI, A. & KRAYENBUHL, H. Ein neuer chirurgischer weg zur behandlung der hydr-und syringomyelia. Schweiz. med. Wschr.. 99:1137, 1969.
3. BOMAN, K. .& IIVANAINEN, M. Prognosis of syringomyelia. Acta neurol. Scand. 43:61, 1967.
4. BONNAL, J.; WINTGENS, M. & STEVENAERT, A. Syringomyélie pseudo-tumorale avec cyphoscoliose chez un garçon de 16 ans. Acta neurochir. 17:280, 1967.
5. BRADAC, G. B. The value of gas myelography in the diagnosis of syringomyelia. Neuroradiology 4:41, 1972.
6. CONWAY, L. W. Radiographic studies of syringomyelia. The hydrodynamics of the syrinx in relation to therapy. Trans. Amer. neurol. Ass. 86:205, 1961.
7. CONWAY, L. W. Hydrodinamic studies in syringomyelia. J. Neurosurg. 27:501, 1967.
8. ELLERTSSON, A. B. Semiologic diagnosis of syringomyelia related to roentgenologic findings. Acta neurol. Scand. 45:385, 1969.
9. ELLERTSSON, A. B. Syringomyelia and other cystic spinal cord lesions. Acta neurol. Scand. 45:403, 1969.
10. ELLERTSSON, A. B. & GREITZ, T. The distending force in the production of communicating syringomyelia. Lancet 1:1234, 1970.
11. FOSTER, J. B.; HUDGSON, P. & PEARCE, G. W. The association of syringomyelia and congenital cervico-medullary anomalies: pathological evidence. Brain 92:25, 1969.
12. GARDNER, W. J. Anatomic anomalies common to myelomeningocele of infancy and syringomyelia of adulthood suggest a common origen. Cleveland Clin. Q. 26:118, 1959.
13. GARDNER, W. J. Diastematomyelia and the Klippel-Feil syndrome. Cleveland Clin. Q. 31:19, 1964.
14. GARDNER, W. J. Hydrodynamic mechanism of syringomyelia: its relationship to myelocele. J. Neurol. Neurosurg. Psychiat. 28:247, 1965.
15. GARDNER, W. J. Embryologic origin of spinal malformation. Acta radiol. 5:1013, 1966.
16. GARDNER, W. J. & ANGEL, J. The mechanisms of syringomyelia and its surgical correction. Clin. Neurosurg. 6:131, 1958.
17. GULEWICS, E. Wyniki leczenia jamistosci rdzenia proieniami roentgena. Neurologia Neurochir. pol. 2:611, 1968.
18. HEINZ, E. R.; SCHLESINGER, E. B. & GORDON POTTS, D. Radiologic signs of hydromyelia. Radiology 86:311, 1966.
19. LASSMAN, L. P.; MICHAEL JAMES, C. C. & FOSTER, J. B. Hydromyelia J. neurol. Sci. 7:149, 1968.
20. LOVE, J. G. & OLAFSON, R. A. Syringomyelia: a look at surgical therapy. J. Neurosurg. 24:714, 1966.
21. MAGEE, K. R. & SCHNEIDER, R. C. Loss of deep-pain sensation without otherwise normal sensory perception. J. Am. med. Ass. 200:795, 1967.
22. McRAE, D. L. & STANDEN, J. Roentgenologic findings in syringomyelia and hydromyelia. Am. J. Roentg. 98:695, 1966.
23. McILROY, W. J. .& RICHARDSON, J. C. Syringomyelia: a clinical review of 75 cases. Can. med. Ass. J. 93:731, 1965.
24. MORRIS, M. F. The central canal. Radiography 35:159, 1969.
25. NEWTON, E. J. Syringomyelia as a manifestation of defective fourth ventricular drainage. Ann. R. Coll. Surg. 44:194, 1969.
26. PITTS, F. W. & GROFF, R. A. Syringomyelia: current statuts of surgical therapy. Surgery 56:806, 1964.
27. RODRIGUEZ VALLEJO, J.; PORTERA, A.; GUTIÉRREZ DEL OLMO, M. C. & MATA, P. Revision del concepto de siringomielia com especial referencia al tipo "comunicante" por defecto en el drenage del cuarto ventriculo. Rev. clin. Esp 120:363, 1971.
28. TJADEN, R. J.; ETHIER, R.; VEZINA, J. L. & MELANÇOM, D. Iodoventriculography in hydromyelia. J. Can. Ass. Radiol. 20:265, 1969.
29. WILLIAMS, B. The distending force in the production of "communicating syringomyelia". Lancet 2:189, 1969.
30. WILLIAMS, B. Syringomyelia. British med. J. 1:434, 1970.
31. WILLIAMS, B. The distending force in the production of communicating syringomyelia. Lancet 2:41, 1970.

Datas de Publicação

Publicação nesta coleção
15 Abr 2013
Data do Fascículo
Dez 1973

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. APPLEBY, A.; BRADLEY, W. G.; FOSTER, J. B.; HANKINSON, J. & HUDGSON, P. Syringomyelia due to chronic arachnoiditis at the foramen magnum J. neurol. Sci. 8:4541, 1969.

[2] 2. BENINI, A. & KRAYENBUHL, H. Ein neuer chirurgischer weg zur behandlung der hydr-und syringomyelia. Schweiz. med. Wschr.. 99:1137, 1969.

[3] 3. BOMAN, K. .& IIVANAINEN, M. Prognosis of syringomyelia. Acta neurol. Scand. 43:61, 1967.

[4] 4. BONNAL, J.; WINTGENS, M. & STEVENAERT, A. Syringomyélie pseudo-tumorale avec cyphoscoliose chez un garçon de 16 ans. Acta neurochir. 17:280, 1967.

[5] 5. BRADAC, G. B. The value of gas myelography in the diagnosis of syringomyelia. Neuroradiology 4:41, 1972.

[6] 6. CONWAY, L. W. Radiographic studies of syringomyelia. The hydrodynamics of the syrinx in relation to therapy. Trans. Amer. neurol. Ass. 86:205, 1961.

[7] 7. CONWAY, L. W. Hydrodinamic studies in syringomyelia. J. Neurosurg. 27:501, 1967.

[8] 8. ELLERTSSON, A. B. Semiologic diagnosis of syringomyelia related to roentgenologic findings. Acta neurol. Scand. 45:385, 1969.

[9] 9. ELLERTSSON, A. B. Syringomyelia and other cystic spinal cord lesions. Acta neurol. Scand. 45:403, 1969.

[10] 10. ELLERTSSON, A. B. & GREITZ, T. The distending force in the production of communicating syringomyelia. Lancet 1:1234, 1970.

[11] 11. FOSTER, J. B.; HUDGSON, P. & PEARCE, G. W. The association of syringomyelia and congenital cervico-medullary anomalies: pathological evidence. Brain 92:25, 1969.

[12] 12. GARDNER, W. J. Anatomic anomalies common to myelomeningocele of infancy and syringomyelia of adulthood suggest a common origen. Cleveland Clin. Q. 26:118, 1959.

[13] 13. GARDNER, W. J. Diastematomyelia and the Klippel-Feil syndrome. Cleveland Clin. Q. 31:19, 1964.

[14] 14. GARDNER, W. J. Hydrodynamic mechanism of syringomyelia: its relationship to myelocele. J. Neurol. Neurosurg. Psychiat. 28:247, 1965.

[15] 15. GARDNER, W. J. Embryologic origin of spinal malformation. Acta radiol. 5:1013, 1966.

[16] 16. GARDNER, W. J. & ANGEL, J. The mechanisms of syringomyelia and its surgical correction. Clin. Neurosurg. 6:131, 1958.

[17] 17. GULEWICS, E. Wyniki leczenia jamistosci rdzenia proieniami roentgena. Neurologia Neurochir. pol. 2:611, 1968.

[18] 18. HEINZ, E. R.; SCHLESINGER, E. B. & GORDON POTTS, D. Radiologic signs of hydromyelia. Radiology 86:311, 1966.

[19] 19. LASSMAN, L. P.; MICHAEL JAMES, C. C. & FOSTER, J. B. Hydromyelia J. neurol. Sci. 7:149, 1968.

[20] 20. LOVE, J. G. & OLAFSON, R. A. Syringomyelia: a look at surgical therapy. J. Neurosurg. 24:714, 1966.

[21] 21. MAGEE, K. R. & SCHNEIDER, R. C. Loss of deep-pain sensation without otherwise normal sensory perception. J. Am. med. Ass. 200:795, 1967.

[22] 22. McRAE, D. L. & STANDEN, J. Roentgenologic findings in syringomyelia and hydromyelia. Am. J. Roentg. 98:695, 1966.

[23] 23. McILROY, W. J. .& RICHARDSON, J. C. Syringomyelia: a clinical review of 75 cases. Can. med. Ass. J. 93:731, 1965.

[24] 24. MORRIS, M. F. The central canal. Radiography 35:159, 1969.

[25] 25. NEWTON, E. J. Syringomyelia as a manifestation of defective fourth ventricular drainage. Ann. R. Coll. Surg. 44:194, 1969.

[26] 26. PITTS, F. W. & GROFF, R. A. Syringomyelia: current statuts of surgical therapy. Surgery 56:806, 1964.

[27] 27. RODRIGUEZ VALLEJO, J.; PORTERA, A.; GUTIÉRREZ DEL OLMO, M. C. & MATA, P. Revision del concepto de siringomielia com especial referencia al tipo "comunicante" por defecto en el drenage del cuarto ventriculo. Rev. clin. Esp 120:363, 1971.

[28] 28. TJADEN, R. J.; ETHIER, R.; VEZINA, J. L. & MELANÇOM, D. Iodoventriculography in hydromyelia. J. Can. Ass. Radiol. 20:265, 1969.

[29] 29. WILLIAMS, B. The distending force in the production of "communicating syringomyelia". Lancet 2:189, 1969.

[30] 30. WILLIAMS, B. Syringomyelia. British med. J. 1:434, 1970.

[31] 31. WILLIAMS, B. The distending force in the production of communicating syringomyelia. Lancet 2:41, 1970.