Syringomyelia (Syrinx)

Syringomyelia (AKA spinal syrinx) is a cystic cavitation of the spinal cord.  Syringomyelia may be divided into specific subtypes (based on etiology, cell type of lining, or presence/absence of communication with the central canal).  For example, syringomyelia may be associated with certain congenital or neoplastic conditions, or may follow significant spinal trauma (with or without clinical spinal cord injury).

Two Main Types of Syringomyelia

Communicating Syringomyelia

Primary dilatation of the central canal of the spinal cord.  This condition is almost always associated with abnormalities of the foramen magnum, for example, Chiari Type I Malformation (the most common form) or Basilar Arachnoiditis (post infectious or idiopathic).  Simple central canal dilatation with ependymal cell lining is called a Hydromyelia, whereas extension into the spinal cord tissue constitutes true syringomyelia.

Noncommunicating Syringomyelia

Cyst arises in cord substance and does not communicate with the central canal or subarachnoid space.  May be due to trauma, neoplasm (most gliomas), or arachnoiditis.  True syrinx cavities contain fluid of the same constituency as CSF, whereas tumor cyst fluid is usually highly proteinaceous.

Symptoms of Syringomyelia

Symptoms of syringomyelia are highly variable and most symptoms progress slowly over several years.  Sensory loss is common particularly loss of pain and temperature sensation with preserved touch and joint position sense.  This leads to painless ulcerations from unperceived injuries.  Patients may also experience cervical and occipital pain and hand and arm weakness.

Treatment of Syringomyelia

Syringomyelia may be treated expectantly with clinical and radiographic follow-up in asymptomatic cases.  However, worsening symptoms and enlarging syrinx on imaging studies may warrant surgical intervention.  Treatment of syringomyelia may involve surgical decompression of the brainstem if the syrinx is due to posterior anomalies such as Chiari I malformation.  In other cases, a shunt can be used to divert fluid from within the cyst to the peritoneum or locally to the subarachnoid space.

At Princeton Neurological Surgery, Dr. Lipani is a board certified fellowship trained spine surgeon in New Jersey who performs minimally invasive spine surgery as well as complex spinal procedures. Dr. Lipani is a specialist in the treatment for syringomyelia AKA spinal syrinx and many other spinal conditions such as spinal stenosis, herniated discs, degenerative disc disease, low back pain, neck pain, spinal tumors, spinal cancer and more. Dr. Lipani treats patients from around the world, New York, Pennsylvania, and New Jersey including locally from Princeton, New Brunswick, Hopewell, Pennington and communities throughout Somerset, Middlesex, Ocean, Burlington, Monmouth and Mercer Counties for syringomyelia. Dr. Lipani offers image guided spine surgery approaches for syringomyelia treatment, tailored to the needs of each patient. For state-of-the-art syringomyelia treatment, call or email us to schedule a consultation at our offices in Hamilton, New Jersey or Bridgewater, New Jersey!

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