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A fluid-filled cyst that forms inside the spinal cord

Syringomyelia is considered to be one of the most intriguing conditions in neurosurgery. In patients with this condition, a fluid cyst (or cysts) forms inside the spinal cord.

Medical specialists still aren’t certain how this fluid gets into the spinal cord in the first place, which is why the disorder is regarded as somewhat of a physical conundrum.

Chiari malformation (also known as Arnold-Chiari malformation) is a congenital condition in which the cerebellum (the back part of the brain) is squeezed out into the spine or upper part of the neck (as opposed to within the skull). This blocks the normal flow of fluid between the head and spine.

Symptoms

Signs and symptoms of syringomyelia, which might affect your back, shoulders, arms or legs, can include:

  • muscle weakness and wasting (atrophy)
  • loss of reflexes
  • loss of ability to feel pain and temperature
  • headaches
  • stiffness
  • pain in the neck, arms and back
  • spinal curvature (scoliosis).

Two of the most common underlying causes of syringomyelia are spinal cord injury and Chiari malformation.

Syringomyelia can also be caused by:

  • tumours
  • infections
  • previous haemorrhage, and
  • past investigations (for example, certain dyes previously injected into the spinal fluid that have resulted in scarring and inflammation around the spinal cord).

However, it’s not always possible to determine the reason why a patient has developed syringomyelia.

The surgeons at Macquarie Neurosurgery use very sophisticated imaging technology—considered to be the best in the country—to try to identify the origin of the condition.

This helps to ensure that patients receive the ideal treatment for their unique case, as different underlying causes require different approaches to surgery and treatment.

Some patients have membranes around their spinal cord that, if formed in such a way that normal fluid circulation is impeded, can lead to syringomyelia. These membranes aren’t visible on normal magnetic resonance imaging (MRI), but the specific technology at Macquarie University Hospital allows the surgical team to see these more easily.

In many cases, this cutting-edge equipment has enabled surgeons to identify the underlying cause of a patient’s syringomyelia when it wasn’t previously apparent.

Surgical treatment is the only option for syringomyelia caused by Chiari malformation.

Macquarie Neurosurgery’s surgeons have many years of experience in performing these types of complex surgical procedures and will determine your treatment options with a multidisciplinary team. This specialist group is dedicated to ensuring you receive an excellent standard of care and support — before, during and after your surgery.

Important considerations for patients undergoing surgery for syringomyelia include:

  • scarring – certain types of patch grafts carry risks of scarring around the cerebellum, which can lead to long-term problems. The surgeons at Macquarie Neurosurgery use patch grafts aimed to minimise scarring.
  • treatment of previous scarring – our medical specialists are able to treat patients who have developed a problem with scarring from previous surgery. They have even had success replacing previous patch grafts.
  • fluid control – the surgical team are highly trained to minimise fluid leakage problems after surgery.
  • shunt surgery – a procedure that diverts fluid from inside the spinal cord, usually to the normal fluid space around the cord. The team has a high level of skill in this technically challenging surgery.

Our academic neurosurgeons began their focus on these conditions over 20 years ago, and have made significant advancements in the field since then.

Their ongoing research has led to a deeper understanding of the causes and treatments of these rare neurological diseases, helping to ensure more accurate diagnoses and better patient outcomes.