Back pain or radiating pain to a nearby area that becomes progressively worse can have many causes, with the most common sources being disc herniation affecting nearby nerve roots and muscle strain. If these causes are ruled out, doctors often look at less common sources involving other things that may affect the spine. In some cases, the spine-related pain may be linked to the development of a fluid-filled cyst called a syrinx that can be located within the spinal cord, where it’s referred to as a rare condition known as syringomyelia, or in the brainstem, where it’s called syringobulbia. Like other spinal conditions, treating a syrinx may involve minimally invasive spine surgery. Beverly Hills spine surgeons share some basic information related to syrinxes.
What Causes Syrinxes?
A fluid-filled cavity in the spine or brainstem may develop due to some type of trauma to the spine. It’s often related to an abnormality in the brain known as a Chiari type 1 malformation (CM1) that may result in part of the cerebellum (located behind the brainstem) protruding onto the spinal cord. The resulting cyst grows gradually and expands outward from where it’s located. Thirty percent of people who have spinal cord tumors eventually develop a syrinx, although meningitis, arachnoiditis (an inflammatory disorder), and hemorrhages can also increase the risk of cysts forming in the upper spine or brainstem.
Symptoms related to a syrinx may include:
- An inability to sense temperature or pain
- Back, shoulder, arm, or leg pain that gradually gets worse
- Trouble walking
- Problems with bladder/bowel functions
- Scoliosis (abnormal curvature of the spine)
- Facial numbness or pain
How Are Syrinxes Diagnosed?
While all symptoms a patient reports will be considered, it’s the reduced sensitivity to pain and temperature that often suggests a syrinx may be the source of the problem. A patient’s medical history is also considered. A referral may be made to a neurologist for further evaluation. Positive diagnosis of a syrinx is typically done with an MRI of the brain and spinal cord with gadolinium (a contrast media that makes it easier to confirm the cyst’s location).
What Are Treatment Options for Syrinxes?
If symptoms are nonexistent or mild, only periodic monitoring may be necessary to track the progression of the cyst’s growth. The only effective treatment for a syrinx when symptoms are severe or potentially life-threatening is surgery to drain the cyst. A small, flexible tube (shunt) may also be used to drain it, which usually corrects related issues with the flow of a clear fluid (cerebrospinal fluid) that cushions the lower rear part of the brain. Antibiotics are given after surgery to prevent infection.
Treatment may also involve:
- Correction of contributing factors (removal of a tumor, repair of damage to the spine)
- Follow-up physical therapy to strengthen muscles that were weakened by the condition
- Additional surgery to expand the base of the skull if a CM1 abnormality is present
Issues related to a syrinx can be difficult to diagnose since some symptoms are similar to what’s often experienced with other sources of spine-related pain. Other than trying to keep your spine as healthy as possible with a balanced, nutrient-rich diet and regular exercise, there’s no standard recommendation for preventing syrinxes from developing. Any usual discomfort that lingers or becomes progressively worse should be evaluated by your doctor or a spine specialist.
Whether you have a syrinx or another spinal condition, there is a solution for alleviating your discomfort. At The Spine Institute, we specialize in a wide array of procedures, from fusion surgery to spinal cord stimulation. Beverly Hills patients can trust in Dr. Bae and his team of expert surgeons to find the best solution to help you find relief. Call 310-828-7757 today to schedule an appointment.