When your spinal cord develops a cyst filled with fluid, it’s called syringomyelia. Treatments for this condition can help relieve pain, but severe syringomyelia may leave permanent neurological damage.
Syringomyelia is a rare disorder in which a fluid-filled cyst forms within your spinal cord. This cyst is referred to as a syrinx and the fluid making up the cyst is called cerebrospinal fluid, also referred to as CSF fluid.
As the syrinx expands and lengthens over time, it compresses and damages part of your spinal cord from its center outward.
Damage to the spinal cord caused by a syrinx can lead to symptoms like progressive pain, stiffness, and weakness in the:
- back
- shoulders
- arms
- legs
People with the disorder might lose the ability to feel cold and pain normally. Some people with this disorder won’t have any symptoms and won’t need treatment. For others, syringomyelia will cause symptoms and complications that worsen as the syrinx expands.
Treatment aims to relieve the pressure on your spinal cord. The treatment your doctor suggests for you will depend on the cause of your syringomyelia. Follow-up care after surgery is important because syringomyelia can reoccur.
Symptoms of this disorder are caused by the pressure the syrinx puts on the spinal cord and the damage that follows. They may include:
You should visit your doctor if you have any of these symptoms. If you’ve had a spinal injury, it’s important to watch for these symptoms. It may take months or even years after your injury for syringomyelia to develop.
Most cases of syringomyelia are chronic disorders caused by a malformation of the brain known as Chiari type 1 malformation (CM1).
CM1 occurs where the brain joins the spinal cord. In this malformation, the brainstem lies lower than usual. Located at the back of the brainstem is the cerebellum.
Often with CM1, the bases of the lobes of the cerebellum, or the cerebellar tonsils, protrude from the skull and into the spinal canal.
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Syringomyelia can also develop as a result of:
- trauma
- meningitis
- hemorrhage
- a tumor
- arachnoiditis
When syringomyelia is caused by a physical illness or trauma, like those above, it’s referred to as acquired syringomyelia. Arachnoiditis is one example of this kind of syringomyelia, which is often caused by surgery, injury, or an epidural injection into the spine.
If a syrinx grows to a large size, you run the risk of damaging your spinal cord. A number of complications can result from permanent nerve damage, including:
- chronic and intense pain
- paralysis of the hands and arms
- stiffness in the legs and uncoordinated movement
- involuntary muscle contractions, or twitches
- scoliosis
- loss of feeling over the shoulders and back area
If your doctor suspects you have syringomyelia, you may be referred to a neurologist, a specialist in treating the nervous system.
To diagnose your condition, your neurologist will first take your complete medical history. A complete physical examination will also be performed. Be prepared to tell your neurologist about your symptoms and how long you’ve had them.
If your neurologist thinks you may have syringomyelia, they’ll order an MRI scan to look for a syrinx in your spinal cord. An MRI scan is considered to be the most reliable diagnostic tool for syringomyelia.
If your MRI is not showing signs of syringomyelia, your doctor may order additional tests using radiography or a CT scan. A CT scan could help look for other spinal abnormalities.
Treatment depends on the progression of the disorder and whether you’re experiencing symptoms that disrupt your life. If you have no symptoms or mild symptoms, you may not need treatment. Your neurologist will monitor the progression of the disorder.
If your symptoms are negatively affecting your life, your neurologist may recommend medications like gabapentin (Neurontin) which may help decrease the painful sensation in the shoulders and arms that frequently occur with syringomyelia.
Another option to treat syringomyelia is to have surgery. This may involve:
After surgery, you may be prescribed a course of antibiotics to prevent complications from an infection. Your doctor may also recommend physical therapy, which can help strengthen muscles in limbs that have progressive weakness.
The outlook of those who undergo treatment and have a successful surgery varies. Damage to the spinal cord may be severe enough to cause permanent neurological issues.
Some people may experience difficulty walking or permanent weakness in their limbs. After the syrinx has been treated, the hope is that these conditions will slowly improve with physical therapy and time.
It’s important to attend follow-up appointments with your doctor. You’ll need periodic MRI scans because syringomyelia can reoccur.