Syringomyelia is a condition in which a fluid-filled hollow forms inside the spinal cord. This cavity is called a spinal syrinx. Of all the spinal diagnoses that a patient can receive, this one is truly fear-inspiring for very good reason.
This terrible disorder is often diagnosed as hydromyelia, although there is one technical difference between the 2 conditions. When a syrinx forms, there are no protective ependymal cells buffering the neurological white tissue of the spinal cord from the invasive fluid accumulation. In hydromyelia, the protective ependymal cells are still present, providing some semblance of hope that the condition may not affect the functionality of the individual for some time.
A syrinx may be stable or unstable, with each case demonstrating a unique profile. Likewise, some spinal syrinx are symptomatic, while others are not.
This essay examines the causes and consequences of syrinx formation within the spinal cord.
A spinal syrinx is a cavity inside the spinal cord which fills with cerebral spinal fluid. This fluid is circulated actively throughout the spinal canal and around the brain.
The CSF helps to nourish the spinal structures and eliminates waste products. When we are first developing, this fluid exists inside and around the entire spinal cord, yet as we age, the cord seals off and should not demonstrate abnormal fluid build up. Due to a variety of reasons, fluid can accumulate inside the cord, potentially increasing the size of the syrinx until it damages the cord, causing dire or even fatal consequences.
For a horrific visual, picture a water balloon slowly filling with fluid until it ruptures. Unfortunately, this imaginary balloon is really the incredibly sensitive tissue of the spinal cord. As the fluid builds up, the cells are slowly crushed to death by the growing pressure.
The most common cause of spinal syrinx occurrence is a condition known as Arnold Chiari malformation. This describes a disorder in which the cellebellar tonsils and the medulla descend down through the foramen magnum, creating a blockage in the normal flow of cerebral spinal fluid into the spinal canal. This often results in a syrinx formed in the cervical or upper thoracic region.
Traumatic spinal cord injury can also cause a syrinx to form virtually anywhere in the cord.
Some people experience idiopathic syrinx formation for reasons which are unknown. However, many of these cases are likely to be congenital defects, in which parts of the interior spinal cord never fully closed off.
Any syrinx may or may not progress and expand, but scenarios with a known causative component, such as Chiari, have a greater chance of becoming problematic, unless the source is corrected surgically. Some congenital syrinxes never cause any health issues whatsoever.
Patients with troublesome syrinxes have few options for treatment. If the syrinx continues to expand, symptoms will likely occur and may be debilitating. Surgery is possible to drain the syrinx, but statistics show that most will recur despite the placement of drains and shunts. There are few effective long-term solutions for syrinx formation, except to diagnose and correct the possible causations, which may stabilize or even reduce the syrinx cavity.
I always advise seeking care from a specialist in spinal neurology when dealing with any potential syrinx. Most patients will remain under the close scrutiny of a neurosurgeon, who may eventually have to make the decision to operate or risk loss of functionality or life.
When I was diagnosed with a syrinx in my thoracic region in 2009, I was devastated. However, subsequent testing did not show the same result and it seems the diagnosis may have been made in error due to a small congenital or developmental defect. I am still monitoring the condition with my neurologist and hoping that all turns out well, for this spinal issue is one which may become a dire health crisis if it does truly exist.