Syringomyelia is a generic term referring to a disorder in which a fluid filled cavity forms within the spinal cord. This cavity, called a syrinx, can expand and elongate over time, and cause damage to the spinal cord. The damage may result in pain, paralysis, weakness, and stiffness in the back, shoulders, or extremities. Syringomyelia may also cause a loss of the ability to feel extremes of hot or cold, especially in the hands. The disorder often leads to a cape-like loss of pain and temperature sensation along the back and arms. Each patient experiences a different combination of symptoms. These symptoms typically vary depending on the extent and, often more critically, to the location of the syrinx within the spinal cord.
Syringomyelia has a prevalence estimated at 8.4 cases per 100,000 people. Symptoms most often begin in adolescence or in young adulthood. Signs of the disorder tend to develop slowly, although a more rapid onset may occur with coughing, straining.
It has been observed that obstruction of the cerebrospinal fluid spaces in the subarachnoid space can result in syrinx formation. A number of pathological conditions can cause an obstruction of the normal cerebrospinal fluid spaces. These include Chiari malformation, spinal arachnoiditis, scoliosis, spinal vertebrae misalignment, spinal tumors, spina bifida, and others. The reasons that blockage of the cerebrospinal fluid space within the subarachnoid space can result in syrinx formation may vary depending on the type of cerebrospinal fluid blockage.
NIH studies of the pulsatile blockage of cerebrospinal fluid flow across the cranio-cervical junction caused by a Chiari I malformations have revealed evidence of pulsatile pressure increases within the spinal fluid space below the Chiari malformation. Evidence also suggests that those pulsatile fluid pressure increases within the spinal fluid space tend to push spinal fluid along vascular channels into the spinal cord and cause syrinx formation.
Surgeries have been developed to treat symptomatic and progressive syringomyelia. Surgery of the spinal cord, though, has certain, characteristic risks associated with it and the benefits of a surgical procedure on the spine have to be weighed against the possible complications associated with any procedure. The first line of surgical treatment is generally aimed at correcting the condition that allowed the syrinx to form. That usually requires removal or alteration of that which is causing a blockage of cerebrospinal fluid flow.
In some patients it may become necessary to drain the syrinx, which can be accomplished using a catheter, drainage tubes, and valves. This system is also known as a shunt.
It is vital to bear in mind that the drainage of a syrinx does not necessarily mean the elimination of the syrinx-related symptoms, but rather is aimed at stopping progression.