Syringomyelia

The human spine is formed by individual vertebrae and connective tissue discs in between. The vertebrae form the spinal canal. There are seven cervical, twelve thoracic, and five lumbar vertebrae. The intervertebral discs are the link between the individual vertebral bodies.

The little joints that link the vertebrae together are known as facet joints. They help to stabilize the spine and, together with the intervertebral discs, allow a certain degree of mobility of the spinal cord. The spinal canal should be wide enough to allow nerve roots to float freely in cerebrospinal fluid. The front border of the spinal canal is built by the vertebral bodies and intervertebral discs, the side by the intervertebral joints (facets) and back by the ligamentum flavum (yellow band) and vertebral arches. Discs consist of an outer fibrous ring (annulus fibrosus), which surrounds an inner gel-like center (nucleus pulposus). The spinal cord and nerve roots lie within the spinal canal. The spinal cord extends downwards approx. to the 1st lumbar vertebra. Below, only nerve roots are present in the spinal canal. At the level of the intervertebral disc the nerve roots pass through the neural root foramina to exit the spinal canal. The spinal cord and nerve roots conduct electric-like signals from the skin and joints to the brain, and process of movement is initiated from the brain to the muscles.

Syringomyelia is a fluid-filled cyst (syrinx) within thе spinal cord. Over time, the cyst may become enlarged and may damage the spinal cord. Syringomyelia occurs most often due to spinal cord compression (e.g. Chiari malformation, tumors, etc), spinal cord injuries and inflammation. In some patients, syringomyelia is a progressive disorder causing pain and paralysis. Others have no associated symptoms.

Gradually progressing damage to the spinal cord

Patients usually have no symptoms.

Numbness, weakness, stiffness in the limbs and ataxic gait. Symptoms begin gradually and tend to worsen over months and years.

Treatment is usually non-surgical.

Progression of symptoms

Removing the obstruction of CSF flow

Relieve the pressure that the syrinx puts on the spinal cord

Draining the syrinx

To stop the worsening of the symptoms

To improve symptoms (e.g. pain reduction)

Drainage of syrinx

Spinal cord decompression