Evidence map›Paper›PMID 42191869›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026

Thecoperitoneal shunt placement for extensive spinal adhesive arachnoiditis or lumbosacral outlet obstruction with syringomyelia.

Fan Yuan, Chenghua Yuan, Chao Chang, Tailai Li, Hao Wu, Zan Chen, Marcus A Stoodley, Fengzeng Jian, Jian Guan

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Fan Yuan *Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Chenghua Yuan *Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Chao Chang *Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Tailai LiEye Hospital, Wenzhou Medical University(Zhejiang Eye Hospital), Zhejiang, China.
Hao WuDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Zan ChenDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
Marcus A StoodleyFaculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.
Fengzeng JianDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. jianfengzeng@xwh.ccmu.edu.cn.
Jian GuanDepartment of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China. guanjian@xwh.ccmu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe pathways of clearance of cerebrospinal fluid (CSF) in the spine remains incompletely understood. While our minimally invasive subarachnoid-subarachnoid bypass technique has demonstrated efficacy in Syringomyelia related to spinal subarachnoid obstruction, its therapeutic utility is significantly limited in extensive spinal adhesive arachnoiditis (ESAA; >5 spinal levels involvement) or Lumbosacral Outlet Obstruction with Syringomyelia. This study evaluates thecal-peritoneal shunting as a novel intervention for ESAA or Lumbosacral Outlet Obstruction with Syringomyelia.

methodsWe prospectively evaluated 20 consecutive Extensive Spinal Adhesive Arachnoiditis or Lumbosacral Outlet Obstruction with Syringomyelia patients undergoing thecal-peritoneal shunting, with a mean follow-up of 14 months (range 12-20 months). Intraspinal pressure was measured intraoperatively at sites cranial to arachnoid adhesions and preoperatively caudal to adhesions during myelography. Twenty baseline-matched small spinal meningioma or schwannoma patients served as controls with intraoperative pressure measurements.

resultsThe procedure yielded clinical improvement in 16 patients (80%), with 4 (20%) maintaining stable symptoms. Radiological assessment demonstrated syrinx reduction in 10 patients (50%). Transient complications occurred in 4 cases (20%; headache [n = 3], fever [n = 1]), all resolving within two weeks. Pressure analysis revealed significantly elevated cranial versus caudal pressures relative to adhesions (P < 0.05), with effective cranial pressure wave normalization post-shunting (P < 0.05).

conclusionsThe thecal-peritoneal shunt represents an effective treatment for Extensive Spinal Adhesive Arachnoiditis or Lumbosacral Outlet Obstruction with Syringomyelia patients, preserving spinal cord integrity while normalizing pathological CSF pressure gradients wave by diverting CSF to the peritoneal cavity and bypassing the impaired lumbosacral drainage buffering pathway.

Indexed as

Cerebrospinal fluidCSF dynamicSpinal cordSyringomyeliaThecal-peritoneal shunt

Identifiers

PMID42191869

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.