Treatment for Syringomyelia

If symptoms are impacting everyday life some form of treatment is recommended. There are two routes available for treating Syringomyelia. 

 

Monitoring

Not all cases are ready or will be eligible for surgical intervention. In these cases, the specialist will treat the individual symptoms or refer to other specialists. Non-surgical options can include pain management, with medications like gabapentin, opiates etc. Physiotherapy, TENS machines, occupational therapy and lifestyle modifications may all be considered. 

 

Surgery

The goal of surgery is to reduce the size of the syrinx improve mobility and motor function and as a result, which reduces the pressure the syrinx puts on the spine and nerves. There is no one surgery that is better and which surgery is performed depends on the cause of the syrinx. 

 

Chiari Decompression Surgery:

Chiari is the most common cause of syringomyelia. By increasing the size of the Posterior Fossa more cerebrospinal fluid (CSF) is able to flow more freely. In most cases, the improved CSF flow from this one surgery will correct both the Chiari and the syrinx. 

 

 

Correcting Blockage: If there is a spinal abnormality or something obstructing the CSF flow (like a tumour), surgery would focus on correcting this is and allowing the improved CSF flow to naturally reduce the syrinx. This can be done by creating space in the lining around the cord by putting a patch in (similar to duraplasty)

 

 

Shunts: When there is no blockage to correct or the syrinx is idiopathic some syrinxes can be drained by the insertion of a shunt. The shunt is a small flexible tube and this is inserted into the subarachnoid area allowing the fluid to flow elsewhere and be absorbed by the body. The shunt is usually a permanent implant. 

Before and After Surgical Treatment