Spinal shunt for arachnoid cyst

  My MRIs remain unchanged but my symptoms have worsened since the surgery to remove an arachnoid cyst three years ago.  My symptoms included burning pain, left leg weakness including drop foot for which I wear an ankle brace.  Pin-***** sensation diminished on the left side up to the site of surgery (T5/6).  Now the doctors are suggesting another surgery to detect and remove another cyst and insert a shunt to allow free flow of spinal fluid.  The cord is still compressed; "atrophied".  They feel that my weakness will continue to progress without surgery.  Questions:  Is anyone familiar with this condition? Is another surgery necessary? What are the success rates?  Hazards?  Please help!  I am taking pamelor, although had more success with elavil and most recently tylenol with codine for the constant pain.  I'd appreciate any input you can give.  Thank you.  Lois
_____________
_____________
Dear Lois,
You may be mixing up the terminology a bit.  Arachnoid cysts are fluid collections in the brain, not typically in the spine.  What you probably have is called a syrinx in the spinal cord.  This, too, is a kind of cyst that can cause problems by causing pressure on the nervous tissue surrounding the fluid collection.  
An MRI is the best way to see what is happening with a syrinx of the spinal cord.  You state that the 'cyst' is the same, but your symptoms are no better, and there is still some compression on the cord.  In this instance a surgeon may consider another surgery to shunt the cyst.  It may
be shunted either internally into the sac around the spinal cord, or externally into the abdomen or lung space.
The bottom line is that if your surgeon thinks you are symptomatic and getting worse from the syrinx ('cyst'), then a shunting procedure is appropriate.  When there are chronic changes in the spinal cord, the procedure often stops the progression of problems, but cannot afford a neurological cure.  In other words you may still have some deficits after surgery due to the chronicity of the disease.
Speak to your surgeon in this regard for better details of his impression and his goals with surgery in your particular situation.  See if he doesn't agree.
Good luck.

[kay_82]

A related discussion, arachnoid cyst in spine was started.