From the Guidelines
A spinal cord shunt at the T7 level is not typically recommended for acute thoracic back pain without myelopathy or radiculopathy, as imaging is not warranted in this setting and the procedure is usually reserved for conditions such as syringomyelia or other causes of CSF accumulation 1. The decision to perform a spinal cord shunt at the T7 level should be based on a thorough evaluation of the patient's condition, including the presence of red flags, prior management, and the results of diagnostic imaging.
- The patient's medical history and current symptoms should be carefully assessed to determine the underlying cause of their condition.
- Diagnostic imaging, such as MRI or CT scans, may be necessary to confirm the diagnosis and determine the extent of any spinal cord or nerve root compression.
- The patient should be informed of the potential risks and benefits of the procedure, including the possibility of shunt malfunction, infection, or neurological damage.
- Post-operative care and follow-up appointments are crucial to ensure proper shunt function and to monitor for any potential complications.
- Pain management should be tailored to the individual patient's needs, with options ranging from acetaminophen or NSAIDs for mild pain to prescription medications like tramadol for more severe pain.
- Patients should be educated on the signs and symptoms of shunt malfunction, such as increased pain, neurological changes, fever, or wound drainage, and should be instructed to seek immediate medical attention if they experience any of these symptoms. The procedure is effective in relieving pressure on the spinal cord and preventing further neurological deterioration in patients with conditions such as syringomyelia or other causes of CSF accumulation, as supported by the study published in the Journal of the American College of Radiology 1.
From the Research
Spinal Cord Shunt T7
- The provided studies do not directly address the topic of a spinal cord shunt at the T7 level.
- However, study 2 discusses the surgical management of multiple thoracic disc herniations, including those at the T7 level.
- The study found that the most commonly involved level was T7-8, with 10 herniations, and that surgical treatment can lead to improved outcomes for patients with symptomatic thoracic disc herniations.
- Study 3 discusses the perioperative management of spinal cord stimulators, but does not specifically address shunts or the T7 level.
- Studies 4, 5, and 6 discuss spinal cord stimulation, syringo-subarachnoid shunts, and epidural spinal cord stimulation, respectively, but do not provide information on spinal cord shunts at the T7 level.
- Therefore, there is limited information available on spinal cord shunts at the T7 level, and further research would be necessary to provide a more comprehensive understanding of this topic.