Study Design
This study was a retrospective single-center cohort study.
Purpose
This study aimed to compare long-term shunt patency by shunt type (syringo-subarachnoid [SS], syringo-pleural [SP], syringo-peritoneal [SPt]) and disease etiology (post-traumatic, post-infectious, idiopathic) in patients surgically treated for syringomyelia, using Kaplan-Meier survival methodology. Overview of Literature: Syringomyelia shunting carries a well-documented revision burden, but direct comparative survival data across shunt modalities and etiologic subgroups are scarce, particularly from East Asian centers.
Methods
We retrospectively analyzed 42 patients (mean age, 47.6±11.8 years; 57.1% male) who underwent syringomyelia shunting at a tertiary neurosurgical center (January 2000–December 2020) with ≥12 months follow-up. Shunt type was classified as SS (n=12), SP (n=16), or SPt (n=14); etiology as post-traumatic (n=24), post-infectious (n=10), idiopathic (n=6), or hemorrhage/tumor-related (n=2). The primary endpoint was shunt revision surgery. Kaplan-Meier analysis, log-rank testing, and Cox proportional hazards regression were performed.
Results
Over a median follow-up of 15 months (range, 12 to 184 months), 16 patients (38.1%) underwent shunt revision. Overall 12- and 24-month patency rates were 79.6% and 72.5%, respectively (median shunt survival 72 months). By shunt type, 12-month patency was 75.0% (SS), 81.3% (SP), and 85.7% (SPt); 24-month patency declined to 48.2% for SS while SP and SPt remained at 81.3% and 85.7% (log-rank p=0.248). Post-infectious syringomyelia showed the shortest median shunt survival (36 months) compared with post-traumatic (not reached) and idiopathic (not reached) groups (log-rank p=0.232). No independent predictor of shunt failure was identified on multivariate Cox regression.
Conclusion
All three shunting techniques achieve approximately 80% one-year patency. SS may carry a higher long-term occlusion risk. Post-infectious syringomyelia requires closer postoperative surveillance. Larger prospective studies are needed to establish definitive shunt selection criteria.

The incidence of compression fractures is increasing in aging populations. Differentiating pathological fracture types is complex and requires careful consideration during diagnosis. This case report describes the clinical course of a 54-year-old female patient presenting with progressive paraplegia after a back injury sustained while lifting a heavy object. Initial imaging revealed a burst fracture at T12 and severe spinal cord compression due to an epidural mass extending from T12 to L2. Clinical assessment raised suspicions of a hematologic malignancy or pathological fractures. Laminectomy and spinal fusion, along with mass removal, resulted in partial improvement in motor function and patient-reported pain levels. However, further evaluation and biopsy revealed chronic inflammation with fibrosis consistent with an unresolved hematoma. This case underscores the importance of a comprehensive differential diagnosis and multidisciplinary collaboration, integrating radiologic, surgical, and pathologic correlation, in the management of complex spinal pathologies.