Syringomyelia


Syringomyelia is a condition where a fluid filled cavity forms in the spinal cord, causing damage to the cord and neurological problems. It is a serious, but rare condition. It effects more men than women and usually is diagnosed after the age of 30.

What causes Syringomyelia?

Brain anatomy  - cross section

Syringomyelia is most often caused by one of 3 mechanisms:

Congenital

A defect called a ‘Chiari Malformation’ is the most common cause of congenital syringomyelia. In this condition, the base of the brain actually lies in the top part of the neck, rather than being contained within the skull. This obstructs the flow of cerebrospinal fluid, eventually leading to the formation of a fluid filled cavity. Over time the size of the cavity grows, putting an increasing amount of pressure on the spinal cord. This type accounts for around 50 % of all cases of syringomyelia.

Spinal cord trauma

This accounts for around 10% of all cases. The defect is caused by direct trauma to the spinal cord; as for example from a car accident or fall from a height.

Spinal cord tumor or infection

The presence of a tumor or infection in the area can rarely lead to a fluid-filled cyst developing.

 

For some people with this condition, there is no obvious cause. The condition is then classed as idiopathic.

 

What are the symptoms of Syringomyelia?

Syringomyelia is a serious condition, but sometimes the symptoms can gradually build up over many years. This can lead to a delay in people seeking treatment and in receiving a diagnosis. Without treatment symptoms will continue to worsen.

Most people with this condition will experience some or all of the following signs and symptoms:

  • Headaches
  • Pain or weakness in the back, neck, shoulders, arms or legs
  • Loss of or changing sensation especially into the hands, including the ability to feel pain
  • Muscle wasting, usually starting in the hands and spreading to the lower and then upper arms
  • Severe pain in the neck and shoulders
  • In severe cases, bladder, bowel and sexual dysfunction may be present.

Syringomyelia may go on to cause paralysis if not treated.

What is the treatment for Syringomyelia?

If the cyst is small, your doctor may advise a ‘wait and see’ approach. Your condition will be closely monitored. For some people, a shunt is used to relieve the pressure on the spinal cord and remove the fluid in the cavity.  Many people with this condition will eventually require surgery.

Surgery for Syringomyelia is aimed at taking the pressure off the spinal cord and nerve roots and preventing further damage. The type of surgery will depend on the underlying cause. If there is a tumor, then the surgeon will try to remove it if possible. In the case of a Chiari Malformation, surgery is aimed at giving the cerebellum more room in the skull and allowing better flow of the cerebrospinal fluid. Your surgeon will discuss with you the particular surgical technique that is right for you and explain fully the recovery process.  Most people will have recovery of neurological impairment after their surgery and a good reduction or removal of pain.