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Treatments and drugs
By Mayo Clinic staffTreatment for syringomyelia depends on the severity and progression of your signs and symptoms.
Monitoring
If syringomyelia is discovered on an MRI scan that's done for an unrelated reason, and it's not causing signs or symptoms, monitoring with periodic MRI and neurological exams may be all that's necessary. In rare cases, a syrinx may resolve on its own without treatment.
Surgery
If syringomyelia is causing signs and symptoms that interfere with your daily life, or if signs and symptoms rapidly worsen, surgery is usually recommended. 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.
Typically, surgery for syringomyelia includes one or more of the following:
- 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, in most cases, resolve syringomyelia.
- Draining the syrinx. To drain the syrinx, your doctor may 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 just outside your spinal cord. The shunt remains inside your spine after surgery. In some cases, your doctor may be able to drain the syrinx during surgery with a small tube (catheter), and a shunt is not required.
- Removing the obstruction. If something within your spinal cord is hindering the normal flow of cerebrospinal fluid, such as a tumor or a bony growth, 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
Follow-up care after surgery is critical because syringomyelia may recur. You'll need regular examinations with your doctor, including periodic MRI tests, to assess the outcome of surgery. Other syrinxes may form, requiring additional surgery. Even after treatment, some signs and symptoms of syringomyelia may remain, as a syrinx can cause permanent spinal cord and nerve damage.
- Syringomyelia fact sheet. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/syringomyelia/detail_syringomyelia.htm. Accessed Dec. 12, 2010.
- Hauser SL, et al. Diseases of the spinal cord. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill; 2008. http://www.accessmedicine.com/content.aspx?aID=2904462&searchStr=syringomyelia#2904462. Accessed Dec. 6, 2010.
- What is syringomyelia? American Syringomyelia & Chiari Alliance Project. http://www.asap.org/syringomyelia. Accessed Dec. 12, 2010.
- Chiari malformation and syringomyelia: A handbook for patients and their families. Chiari and Syringomyelia Foundation. http://www.csfinfo.org/chiari_syringomyelia_cm_sm_handbook. Accessed Dec. 10, 2010.
- Simon RP, et al. Disorders of somatic sensation. In: Aminoff MJ, et al. Clinical Neurology. 7th ed. New York, N.Y.: McGraw-Hill; 2005. http://www.accessmedicine.com/content.aspx?aID=5149281&searchStr=syringomyelia. Accessed Dec. 9, 2010.
- Eisen A. Disorders affecting the spinal cord. http://www.uptodate.com/home/index.html. Accessed Dec. 6, 2010.
- Krauss WE (expert opinion). Mayo Clinic, Rochester, Minn. Dec. 17, 2010.
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