Syringomyelia (Fluid-Filled Cavity in the Spinal Cord)

A condition in which a fluid-filled cavity (cyst) forms within the spinal cord and can enlarge over time, affecting nerve function.

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Congenital Anomalies

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1Overview

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What is this Condition?

Syringomyelia is a usually slowly progressive condition resulting from the formation of a long fluid-filled cavity (cyst) within the spinal cord. This cavity can enlarge over time, exerting pressure on spinal cord tissue and causing disruption of nerve function. It most commonly occurs in the cervical and thoracic spinal cord. The most common cause is Chiari malformation, in which structures from the brainstem and cerebellar region herniate into the spinal canal; spinal cord injury, prior infection, or tumors can also be causative factors. In some cases, no clear cause is identified. Diagnosis is readily made by MRI. Treatment is generally directed at the underlying cause of cyst formation.

Symptoms

Reduction in pain and temperature sensation distributed in a cape-like pattern over the shoulders, arms, and upper trunk (touch sensation is often preserved)

Weakness in the arms and hands, muscle atrophy, progressive loss of fine motor skills

Chronic neuropathic pain with burning or electric shock-like quality

Weakness in the legs, stiffness (spasticity), and balance problems

In advanced cases, impaired bladder and bowel control

If the cyst extends into the brainstem: dysphagia, hoarseness, dizziness, and related symptoms

Diagnosis Methods

MRI imaging is the most important diagnostic tool; on MRI, the fluid-filled cyst (syrinx) within the spinal cord is clearly visualized. Additionally, to identify the underlying cause of the cyst, the brain and craniocervical junction are also evaluated by MRI, allowing investigation of conditions such as Chiari malformation, prior traumatic injury, or tumor. Neurological examination determines the level of the spinal cord involvement.

Treatment Methods

Treatment is planned based on the underlying cause of cyst formation. When the cyst is related to Chiari malformation, surgical decompression of the craniocervical junction (posterior fossa decompression) is performed to relieve compression; this procedure often helps reduce cyst size. In cysts developing after spinal cord injury, drainage of fluid or lysis of adhesions may be considered. If a tumor is present, its treatment takes priority. Small, asymptomatic, and stable cysts can be followed with regular MRI.

Treatment of the underlying cause (craniocervical junction surgery for Chiari): When compression is relieved, cerebrospinal fluid circulation improves and the cyst typically decreases in size.

Surgery for post-traumatic cysts: Lysis of adhesions or redirection of cyst fluid to an appropriate space (shunting) may be considered.

Treatment of tumor-related cysts: Following treatment of the tumor, the cyst usually regresses.

Follow-up: Asymptomatic, small, and stable cysts can be monitored with regular MRI and clinical examination.

Treatment Path

Related Treatments

The procedures and interventions most commonly explored with this condition.

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Craniosynostosis Surgeries

Craniosynostosis Surgeries procedure

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Fronto-Orbital Advancement

Fronto-Orbital Advancement procedure

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Calvarial Reshaping

Calvarial Reshaping procedure

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Oksipitoservikal posterior dekompresyon + duraplasti

Oksipitoservikal posterior dekompresyon + duraplasti procedure

Open treatment detail

References

Greenberg MS. Handbook of Neurosurgery. 10th ed. Thieme; 2023:1404-1412.
Greenberg MS. Handbook of Neurosurgery. 10th ed. Thieme; 2023:295-300.
Steinmetz MP, Berven SH, Benzel EC, eds. Benzel's Spine Surgery. 5th ed. Elsevier; 2022:850.

This content is for informational purposes and based on academic sources; consult your physician for diagnosis and treatment.

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Syringomyelia (Fluid-Filled Cavity in the Spinal Cord)

Congenital Anomalies

1Overview

What is this Condition?

Symptoms

Diagnosis Methods

Treatment Methods

Related Treatments

Craniosynostosis Surgeries

Fronto-Orbital Advancement

Calvarial Reshaping

Oksipitoservikal posterior dekompresyon + duraplasti

References

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