Syringomyelia- What is it?
Mr Sanj Bassi explains to us what is syringomyelia:
Syringomyelia is a fluid filled cyst (syrinx) that develops with the spinal cord. The cyst will get larger over time and will eventually damage the spinal cord.
A syrinx is formed when the cerebrospinal fluid that circulates and protects the brain turn back on itself, down to the spine and collects tissue from the spinal cord which causes a small cyst. The cyst will get bigger as more of the cerebrospinal fluid builds up.
The causes of syringomyelia include, damage or injury to the spinal cord, tumours along the spinal cord and most commonly Chiari malformation.
Patients with syringomyelia may experience some of the symptoms listed below:
Weakness, numbness and stiffness in the back, legs, arms and shoulders
Intense pain in the neck and shoulders and face
Muscle weakness and signs of wasting
Reduced sensitivity (unable to feel hot or cold)
Loss of pain sensation
Bladder and bowel dysfunction
Scoliosis (spinal curvature)
Although symptoms vary from patient to patient, it is normal for them to get early symptoms of weakness in their back, neck, arms and legs or loss reflexes, so it is important to watch out for the signs.
How is syringomyelia diagnosed?
If a patient come in with the above symptoms associated with syringomyelia then a doctor will talk through their medical history and perform a physical examination to look for signs of syringomyelia. The next step is to refer the patient for an MRI or CT scan of the spine. This scan will provide detailed images of the patient’s spine, making it easy to pick up any syrinx on the spinal cord.
What are the different causes of syringomyelia?
Chiara 1 malformation is the main cause of syringomyelia. Chiara malformation is when the bottom part of the brain protrudes the spinal canal.
Other causes of syringomyelia can be injury to the spinal cord, spinal tumour, meningitis or a tethered cord, which is present from birth.
How can syringomyelia be treated?
There are different ways to treat syringomyelia, the treatment option that is chosen for you all depends on the severity and whether it is affecting the patient’s day to day life.
Watch and wait – this option is for patients that have a less disruptive case of syringomyelia and it may have been caught early on where the cyst is still very small. As this condition can be slow growing, it may not be necessary to go ahead with treatments just yet, especially if the patient is not presenting with any symptoms.
Medication – although syringomyelia cannot be treated through medication, it can help some to relieve some of the symptoms that it is causing, such as pain.
Draining the syrinx (shunt) – this is a surgical procedure in which the consultant inserts a tube which drains the fluid build-up in to another area of the body such as the abdomen and prevents backflow.
Other surgical options- removing the tumour or a growth which may be obstructing the spinal cord. If the patient has Chiari malformation then the surgeon will aim to free up and expand the base of the cerebellum and improve the flow of cerebrospinal fluid.
Once the patient has had the syringomyelia treated, they will have to have regular follow ups in case the syrinx comes back. During the follow up appointment’s you doctor will give you scans to see if there have been any changes.
A syrinx can cause permanent damage to the spinal cord even after the patient has had surgery, so it is important that all patients are aware of the risks associated with and without the surgery.
This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.