Artikel
High-performance sports after operated syringobulbia
Hochleistungssport nach operierter Syringobulbie
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Autoren
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A. Aschoff
- Department of Neurosurgery, University of Heidelberg
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K. Geletneky
- Department of Neurosurgery, University of Heidelberg
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D. Rasche
- Department of Neurosurgergy, University of Lübeck
| Veröffentlicht: | 30. Mai 2008 |
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Gliederung
Text
Objective: In 4.5 to 22% of traumatic paraplegics develops a posttraumatic syringomyelia (PTS), which invades in ca. 10% the brainstem (syringobulbia). A neurosurgical intervention is necessary in about 50% of these patients. Physical activity and sports are usually justified as risk factor for development or progression of syringomyelia. The physical endurance and fitness of these patients is demonstrated in three cases.
Results: We present three cases:
Case 1: 10 years after a motorbike accident with complete paraplegia below Th 6 a ascending syringomyelia (Ø 9 mm) with a syringobulbia (5x14 mm) was diagnosed in a young women. We made a hemilaminectomy Th1-2 and implanted a syringo-subarachnoid microcatheter (SSA) into the transparent syrinx, which decreased for ca 60%, but not disappeared. Seven month after SSA the woman showed neurologic full remission and fighted in the German national team for wheel chair basketball in the Paralympics Barcelona. In international ranking she was no.1 over 4 years, continued top sports and is now trainer for basketball. 15 years after the SSA the cervical syrinx is disappeared completely; a residual 6-mm-cyst in the upper thoracal levels may be responsible for new sweating anomalies.
Case 2: The 19-year-old patient suffered a paraplegia below C7 right and C8 left after a motor-cycle accident. Four years later an ascending-descending syringomyelia (Ø 10 mm) was found, which reached into the medulla oblongata and produced progressive symptoms; we implanted a SSA in level Th 2.The syrinx collapsed, clinically full remission. Three years later the patient won the bronze medal in wheel chair marathon at the Paralympics 2000 in Sydney. He continued racings and won the German Wheelchair Marathon 2007 in 2h 17 min in his class.
Case 3: The former German master in wheelchair-nine-pin presented a 8-mm-syrinx with a small syringobulbia, was treated with SSA and continues his sport after collaps and remission
Conclusions:
- 1.
- Even patients with massive syrinxes and syringobulbias are able to perform after successful operations high-performance sports without sideeffects over many years.
- 2.
- The SSA with tiny catheters without sutures on dura can prevent iatrogenous tethered cord with scarring and recidives, which are common after thick implants, especially when fixed on the dura.
