Spinal Syringomyelia

Spinal syringomyelia is a condition that occurs when cerebrospinal fluid (which is normally outside of the spinal cord and brain) enters the interior of the spinal cord. The fluid causes a cavity or cyst, known as a "syrinx," to form inside the spinal cord.

Spinal Syringomyelia Symptoms

A syrinx may grow over time, destroying the center of the spinal cord. This damage tends to cause a pattern of back pain, weakness and stiffness in the back, shoulders, arms or legs. Other syringomyelia symptoms may include:

• Bowel and bladder function problems
• Facial pain or numbness
• Loss of sensitivity to pain and temperature
• Muscle spasms in legs
• Tingling sensation that quickly spreads down the torso and into the legs when you sharply flex your neck.

Syringomyelia symptoms tend to develop slowly, although coughing or straining may cause them to appear suddenly. Straining or any activity that causes cerebrospinal fluid pressure to fluctuate may worsen these syringomyelia symptoms.

Spinal Syringomyelia Causes

Most cases of spinal syringomyelia are related to a congenital abnormality of the brain, called the "Chiari I malformation." This malformation, which occurs during fetal development, causes the lower part of the brain (cerebellar tonsils) to protrude, or herniate, into the cervical spinal canal (neck). The malformation blocks the normal flow of cerebrospinal fluid, which may cause a syrinx to form in the spinal cord. Some doctors call this "communicating spinal syringomyelia."

Other common causes of syringomyelia include:

• Arachnoiditis (inflammation of the arachnoid lining, a membrane surrounding the spinal cord)
• Hemorrhage (bleeding)
• Meningitis
• Trauma or injury
• Tumor.

Syringomyelia symptoms may appear months or years after the initial injury or disease. Symptoms usually start with back pain, weakness, and loss of sensation originating from the injury site. You may hear this condition referred to as "non-communicating spinal syringomyelia."

Spinal Syringomyelia Treatment

If the syringomyelia is causing no symptoms, it's usually left untreated.

If syringomyelia symptoms are present, however, medical professionals usually recommend surgery. The goal of surgical treatment is to remove the pressure the syrinx places on the spinal cord and restore the normal flow of cerebrospinal fluid. The type of necessary surgery depends on the underlying cause of syringomyelia, and may include:

• Chiari malformation surgery: This may involve enlarging the opening at the base of the skull and expanding the covering of the brain (dura).
• Correcting the abnormality: If a spinal abnormality is interfering with the normal flow of cerebrospinal fluid, the goal is to correct the problem.
• Draining the syrinx: A doctor may surgically insert a drainage system, called a "shunt."
• Removing the obstruction: If something, such as a tumor or a bony growth, is interfering with the normal flow of cerebrospinal fluid, it can be removed.

Surgery isn't always effective. In order to manage spinal syringomyelia, you may want to:

• Avoid activities that worsen symptoms, including any activity that involves lifting, straining, or putting excessive force on the spine.
• Take physical therapy to address muscle weakness, back pain, fatigue or stiffness.
• Talk to your doctor about treatment options for chronic back pain.

Sufferers may also find help by joining spinal syringomyelia support groups.

Resources

American Syringomyelia and Chiari Alliance Project Staff. (2008). What is syringomyelia? Retrieved March 23, 2010, from http://www.asap.org/syringomyelia.html

Mayo Clinic Staff. (2008). Syringomyelia. Retrieved March 23, 2010, from http://www.mayoclinic.com/health/syringomyelia/DS01127

National Institute of Neurological Disorders and Stroke Staff. (2010). Syringomyelia fact sheet. Retrieved March 23, 2010, from http://www.ninds.nih.gov/disorders/syringomyelia/detail_syringomyelia.htm