What is a Syrinx After a Spinal Cord Injury?

Of all the strange conditions that can develop after a spinal cord injury, one of the most misunderstood is syringomyelia, more commonly referred to as a syrinx.

A syrinx is an enlarged cyst filled with fluid on the spinal cord. Syringomyelia only affects a small percentage of people with spinal cord injury.

But for those who do experience this dangerous condition, it must be dealt with promptly. Read on to learn everything there is to know about syrinxes after a spinal cord injury.

How to Diagnose a Syrinx?

It's important to mention that cysts by themselves (without any fluid) are rather common among people with spinal cord injuries.

It is suggested that around 50% of people with spinal cord injuries have some kind of cyst around their injury site.

Only 4% of these individuals will have will see their cyst develop into a syrinx (a cyst filled with fluid). This fluid is called cerebrospinal fluid aka spinal fluid.

If spinal fluid is unable to flow naturally in the spinal cord, a syrinx will develop. Doctors also think that certain activities that are intense on the face - such as coughing/quad coughing, sneezing, certain yoga poses, or lifting weights – could cause a syrinx to develop.

In a healthy spinal cord, spinal fluid is able to flow through a spinal cord with ease, but when there is an obstruction, the fluid flows in the cyst and stops.

Pressure then builds in the syrinx which can cause it to enlarge and/or rupture and cause spinal cord injury damage.

How long after a spinal cord injury can a syrinx occur?

A syrinx can occur at almost any time after a spinal cord injury.

For some, a syrinx may develop within weeks of an injury. Others won't develop a syrinx until several years have passed since their spinal cord injury.

Unfortunately, doctors cannot explain why this occurs. There are however several symptoms to be aware of that can point to a possible syrinx.

Some of the most classic symptoms of a syrinx include increased spasticity or decreased spasticity, pain (nerve pain), headaches, worsening balance, decreasing sensory-motor function, dilated pupils, and autonomic dysreflexia/patchy sweating.

People also report insomnia, burning sensations, and vision problems, but vision issues typically don’t occur until the circulation around the spinal cord impairs the syrinx.

Others report feeling lightheadedness due to low blood pressure, as well as difficulty emptying their bladder.

It's important to see a doctor right away if you're experiencing any of the above-mentioned symptoms.

If a syrinx is left untreated, it can lead to even further paralysis. To diagnose a syrinx, your doctor will need you to undergo an MRI to get an accurate picture of what your injury site looks like so they can determine if a syrinx has developed.

You can also try self-diagnosis by utilizing the pin-prick method to test for a loss of sensation and/or temperature, which can be a telltale sign of a syrinx.

Other tests doctors will use to diagnose a syrinx include quantitative strength tests and nerve conduction tests, which can both detect other causes of neurological decline.

Both of these tests are great at monitoring the status of a syrinx and assessing which treatments are working.

Treating a Syrinx

If you are diagnosed with a syrinx, chances are your doctor will want you to undergo surgery to combat it, since surgery is by far the most popular treatment option for syrinxes.

This is because surgery is ideal for stopping a syrinx from expanding. Doctors will often utilize a shunt tube to drain fluid from the spinal cord and into the abdominal cavity.

It's important to note: Those with incomplete injuries who have movement/feeling below their injury level need to be aware of a possible loss of both sensation/movement below the injury level if undergoing a shunt tube procedure.

For example with shunt surgery, there is a possibility of the shunt tube causing the syrinx to close and fill once again with fluid.

Otherwise, a dural graft procedure is done. This creates space around the spinal cord to allow improved flow of spinal fluid through the injury site.

This also reduces pressure. If neither of these methods are successful, a surgeon will sometimes opt for a cordectomy. This is when a doctor cuts across the cyst to release fluid from it.

This latter option can sometimes be construed as the most risky in regards to loss of function, as that can sometimes be caused by the procedure.

Once the syrinx surgery is completed, significant follow-up care is required to prevent the syrinx from redeveloping, which is unfortunately common.

Most doctors will monitor symptoms by having you get a yearly MRI. Rehabilitation is also necessary to help an individual adjust to their new ability if a loss of function has occurred or if they have pain stemming from the syrinx that needs to be managed.

Above all, however, it’s incredibly important to see a doctor right away if you think you’re experiencing any symptoms pointing to a possible syrinx.

Too many people have ignored their symptoms and live in regret for not getting it treated sooner.