It was recently introduced a new concept and technique of treating post traumatic and secondary to Chiari malformation syringomyelia, using a new type of shunt procedure, a syringo-subarachnoid-peritoneal shunt. This technique it has numerous advantages over traditional shunt techniques. We present a case operated in our hospital, with a variant of the above mentioned technique. A 44 years old patient who have a craniocervical decompression surgery in april 2001 to due to Chiari malformation and cervicodorsal syringomyelia. In November 2002 he underwent surgery due to clinical worsening, with derivation of the syrinx to subarachnoid space with acceptable improvement. In may 2015 the patient present with loss of strength in left arm and paraparesis of lower limbs that requires wheelchair permanently. MRI evidence syrigomielic cyst from C1 to T10. It was intervened in may of 2015 with cyst-subarachnoid-pleural using a T tube shunt. Clinical manifestations and radiological findings improved after the operation. We think that this procedure is beneficial method among the various shunting procedures.