Syringo-subarachnoid shunt: how I do it

BACKGROUND: Syringo-subarachnoid shunt (SSS) is a valid method for the treatment of syringomyelia persisting after foramen magnum decompression (FMD) for Chiari I malformation. METHOD: We give a brief overview on indication and outcome of SSS, followed by a detailed description of the surgical anatomy, and of the microsurgical technique. In particular, we highlight some key points for complication avoidance. CONCLUSION: SSS is a valid option to treat syringomyelia, since in experienced hands, the outcome is good in most patients, including those with holocord syringomyelia. Careful understanding of anatomy and spinal cord physiology is required to minimize complications.