Syringomyelia (sih-ring-go-my-E-lee-uh) is the development of a fluid-filled cyst (syrinx) within your spinal cord. Over time, the cyst can enlarge, damaging your spinal cord and causing pain, weakness and stiffness, among other symptoms.
Syringomyelia has several possible causes, though the majority of cases are associated with a condition in which brain tissue protrudes into your spinal canal (Chiari malformation).
Other causes of syringomyelia include spinal cord tumors, spinal cord injuries and damage caused by inflammation around your spinal cord.
If syringomyelia doesn't cause problems, monitoring the condition might be all that's necessary. But if you're bothered by symptoms, you might need surgery.
Syringomyelia symptoms usually develop slowly over time. If your syringomyelia is caused by protrusion of brain tissue into your spinal canal (Chiari malformation), symptoms generally begin between ages 25 and 40.
In some cases, coughing or straining can trigger symptoms of syringomyelia, although neither causes syringomyelia.
Signs and symptoms of syringomyelia, which might affect your back, shoulders, arms or legs, can include:
If you have any of the signs or symptoms associated with syringomyelia, see your doctor.
If you've had a spinal cord injury, watch for signs and symptoms of syringomyelia. Months to years can pass after an injury before syringomyelia develops. Make sure your doctor knows you had a spinal cord injury.
It's unclear how and why syringomyelia happens. When it develops, cerebrospinal fluid — the fluid that surrounds, cushions and protects your brain and spinal cord — collects within the spinal cord itself, forming a fluid-filled cyst (syrinx).
Several conditions and diseases can lead to syringomyelia, including:
In some people, syringomyelia can progress and lead to serious complications. Others have no symptoms.
Possible complications as a syrinx enlarges or if it damages nerves within your spinal cord include:
Your doctor will ask about your medical history and do a complete physical examination. In some cases, syringomyelia might be discovered incidentally during a spine MRI or CT scan conducted for other reasons.
If your doctor suspects syringomyelia, you'll likely undergo tests such as:
MRI. An MRI of your spine and spinal cord is the most reliable tool for diagnosing syringomyelia.
An MRI uses radio waves and a strong magnetic field to produce detailed images of your spine and spinal cord. If a syrinx has developed within your spinal cord, your doctor will be able to view it on the MRI.
In some cases, a specialist will inject a dye into a blood vessel in your groin, which travels through blood vessels to your spine and reveals tumors or other abnormalities.
You might have repeated MRI scans over time to monitor the progression of syringomyelia.
Treatment for syringomyelia depends on the severity and progression of your signs and symptoms.
If syringomyelia isn't causing signs or symptoms, monitoring with periodic MRI and neurological exams might be all you need.
If syringomyelia is causing signs and symptoms that interfere with your life, or if signs and symptoms rapidly worsen, your doctor will likely recommend surgery.
The goal of surgery is to remove the pressure the syrinx places on your spinal cord and to restore the normal flow of cerebrospinal fluid. This can help improve your symptoms and nervous system function. The type of surgery you'll need depends on the cause of syringomyelia.
To reduce pressure on your brain and spinal cord, surgery options include:
Surgery doesn't always restore the flow of cerebrospinal fluid, and the syrinx might remain, despite efforts to drain the fluid from it.
Syringomyelia can recur after surgery. You'll need regular examinations with your doctor, including periodic MRIs, to assess the outcome of surgery.
The syrinx can grow over time, requiring additional treatment. Even after treatment, some signs and symptoms of syringomyelia can remain, as a syrinx can cause permanent spinal cord and nerve damage.
The following steps might help reduce the effects of syringomyelia.
Avoid activity that involves heavy lifting, straining or putting force on your spine.
If syringomyelia causes neurological problems that decrease your mobility and activity, such as muscle weakness, pain, fatigue or stiffness, a physical therapist might be able to create an exercise program for you that can help reduce these symptoms.
Talk to your doctor about physical therapists in your area who have expertise in neurological conditions.
If you have chronic pain from your syringomyelia, talk to your doctor about treatment options. Many medical centers have doctors who specialize in pain management.
Living with syringomyelia and its complications can be challenging. Having someone to talk with, whether a friend, counselor or therapist, can be invaluable. Or you might find the support and encouragement you need in a syringomyelia support group.
Ask your doctor to recommend a local group or look for groups online. Support groups provide a forum for sharing experiences and can be good sources of information, offering useful or helpful tips for people with syringomyelia.
You're likely to start by seeing your family doctor or your doctor might refer you to a doctor trained in brain and nervous system conditions (neurologist).
Here's some information to help you get ready for your appointment.
When you make the appointment, ask if there's anything you need to do in advance, such as restrict your diet. If you have past medical reports, MRI scans or CT scans that might relate to your problem, bring them to your appointment.
Take a family member or friend to your appointment, if possible, to help you remember the information you'll be given.
Make a list of:
For syringomyelia, questions to ask your doctor include:
Your doctor is likely to ask you questions, including:
Avoid doing anything that worsens your symptoms. For many people with syringomyelia, heavy lifting and straining can trigger symptoms, so avoid these activities. Also, avoid flexing your neck.
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