Treatment for syringomyelia depends on the severity and progression of your signs and symptoms.
If syringomyelia is discovered on an MRI scan that's done for an unrelated reason, and syringomyelia isn't causing signs or symptoms, monitoring with periodic MRI and neurological exams may be all that's needed. In rare cases, a syrinx may resolve on its own without treatment.
If syringomyelia is causing signs and symptoms that interfere with your daily life, or if signs and symptoms rapidly worsen, your doctor will usually recommend surgery.
The goal of surgery is to remove the pressure the syrinx places on your spinal cord and to restore the normal flow of cerebrospinal fluid. The type of surgery you'll need depends on the underlying cause of syringomyelia.
Several types of surgery options are available to reduce pressure on your brain and spinal cord. The goal of surgery is to improve your symptoms and nervous system (neurological) function. Surgery types include:
Treating Chiari malformation. If syringomyelia is caused by Chiari malformation, your doctor may recommend surgery that involves enlarging the opening at the base of your skull (suboccipital craniectomy) and expanding the covering of your brain (dura mater).
This surgery can reduce pressure on your brain and spinal cord, restore the normal flow of cerebrospinal fluid, and may improve or resolve syringomyelia.
- Draining the syrinx. To drain the syrinx, your doctor will surgically insert a drainage system, called a shunt. It consists of a flexible tube with a valve that keeps fluid from the syrinx flowing in the desired direction. One end of the tubing is placed in the syrinx, and the other is placed in another area of your body such as your abdomen.
- Removing the obstruction. If something within your spinal cord, such as a tumor or a bony growth, is hindering the normal flow of cerebrospinal fluid, surgically removing the obstruction may restore the normal flow and allow fluid to drain from the syrinx.
- Correcting the abnormality. If a spinal abnormality is hindering the normal flow of cerebrospinal fluid, surgery to correct it, such as releasing a tethered spinal cord, may restore normal fluid flow and allow the syrinx to drain.
Surgery doesn't always effectively restore the flow of cerebrospinal fluid, and the syrinx may remain, despite efforts to drain the fluid from it.
Follow-up care after surgery is critical because syringomyelia may recur. You'll need regular examinations with your doctor, including periodic MRIs, to assess the outcome of surgery.
The syrinx may grow over time, requiring additional treatment. Even after treatment, some signs and symptoms of syringomyelia may remain, as a syrinx can cause permanent spinal cord and nerve damage.
March 25, 2014
- Syringomyelia fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/syringomyelia/detail_syringomyelia.htm. Accessed Sept. 17, 2013.
- Papadakis MA, et al. Current Medical Diagnosis & Treatment 2013. 52nd ed. New York, N.Y.: The McGraw-Hill Companies; 2013. http://www.accessmedicine.com/content.aspx?aID=13162&searchStr=syringomyelia. Accessed Sept. 17, 2013.
- Eisen A. Disorders affecting the spinal cord. http://www.uptodate.com/home. Accessed Sept. 17, 2013.
- Sekula RF, et al. The pathogenesis of Chiari I malformation and syringomyelia. Neurological Research. 2011;33:232.
- NINDS meningitis and encephalitis information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/encephalitis_meningitis/encephalitis_meningitis.htm.Accessed Sept. 18, 2013.
- Brett-Fleegler M. Evaluation of neck stiffness in children. http://www.uptodate.com/home. Accessed Sept. 18, 2013.
- Abrams GM, et al. Chronic complications of spinal cord injury. http://www.uptodate.com/home. Accessed Sept. 18, 2013.
- Muthusamy P, et al. Syringomyelia. First Consult. http://www.clinicalkey.com. Accessed Sept. 17, 2013.
- Noseworthy JH. Neurological Therapeutics: Principles and Practice. London, U.K.: Martin Dunitz; 2003:2520.
- Support & resources: Find support. American Syringomyelia and Chiari Alliance Project. http://asap.org/index.php/resources/find-support/. Accessed Sept. 19, 2013.
- Support groups. American Chronic Pain Association. http://www.theacpa.org/Support-Groups. Accessed Sept. 19, 2013.