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Thread: syrinx?

  1. #1

    syrinx?

    Hello All,

    I have been diagnosed with central canal prominence throughout my thoracic spine. The most focal area is from T8-T9 measuring 1.9 mm in width. I have been told that this would be defined as hydromyelia and that is is a persistent central canal, remnants of development and would not be considered syrinx or syringomyelia. This was told by a Cm/Sm expert. Wondered if anyone out there has been given similar diagnosis. I have had some arms and leg pain, but mostly pain in my right foot that is a burning pain.

  2. #2
    Quote Originally Posted by chiguy View Post
    Hello All,

    I have been diagnosed with central canal prominence throughout my thoracic spine. The most focal area is from T8-T9 measuring 1.9 mm in width. I have been told that this would be defined as hydromyelia and that is is a persistent central canal, remnants of development and would not be considered syrinx or syringomyelia. This was told by a Cm/Sm expert. Wondered if anyone out there has been given similar diagnosis. I have had some arms and leg pain, but mostly pain in my right foot that is a burning pain.
    Chiguy,

    You have an enlarged central canal and not necessarily a syringomyelic cyst. According to one theory (the one that I happen to believe in), syringomyelic cysts (syrinxes) result from occlusion of cerebrospinal fluid (CSF) that normally flow downward from the brain to the spinal cord. About a liter of CSF flows downward each day in the subarachnoid space surrounding the spinal cord. If this flow is occluded, some of the flow is shunted into the central canal which connects to the fourth ventricle.

    If this theory is correct, one should be able to collapse and reverse syrinxes simply by removing adhesions between the CSF and arachnoid and restoring the CSF flow around the spinal cord. Barth Green and his group actually showed that restoring CSF flow around the spinal cord can reverse even large syringomyelic cysts.

    Wise.

  3. #3
    Chiguy,

    You may want a few opinions while you research this, couldn't hurt. Dr. Scott Falci, a surgeon here @ Craig Hospital, specializes in this field. You may want to give him a call: 303-789-8000. Good luck.

  4. #4
    Wise and Chris,

    Thanks for your responses! I have read many of the threads and posts you have on here in regards to this issue, Wise. I have learned a great deal and really appreciate all of your knowlege and input!

    I have had brain scans and MRI's of all three spinal sections. Since the first scan in 2008, nothing has changed in the thoracic area. I have been told by a couple of NS that there is nothing blocking the CSF flow, so that is why I was being told it was a remnant of development.

    Chris, before I had heard this, I did send out my scans to Dr. Falci's office. Great staff and very supportive. I am waiting to hear back from them.'

    Thanks again for the info!

  5. #5

    One Other Question

    Wise,

    I have been doing quite a bit of reading on what you were referring to.....ie, reversing the syrinx. My question for you is the adhesions that you talk about between the CSF and arachnoid, are those visible on MRI scan or would other testing have to be done? As I mentioned, I have had MRI's with/without contrast on all three spinal regions and a Brain MRI. Thanks again for the great info!

  6. #6
    Can a whiplash injury present what is being found in my thoracic spine? I have played whirlyball, a bumper car basketball, and that would be the only neck trauma (in the form of whiplash) that I can think of.... no falls, etc.

    How would treatment for this type of syrinx look if it is a syrinx? Would the same methods as above be used?

    Thanks for all your time!

  7. #7
    Quote Originally Posted by Wise Young View Post
    Chiguy,

    You have an enlarged central canal and not necessarily a syringomyelic cyst. According to one theory (the one that I happen to believe in), syringomyelic cysts (syrinxes) result from occlusion of cerebrospinal fluid (CSF) that normally flow downward from the brain to the spinal cord. About a liter of CSF flows downward each day in the subarachnoid space surrounding the spinal cord. If this flow is occluded, some of the flow is shunted into the central canal which connects to the fourth ventricle.

    If this theory is correct, one should be able to collapse and reverse syrinxes simply by removing adhesions between the CSF and arachnoid and restoring the CSF flow around the spinal cord. Barth Green and his group actually showed that restoring CSF flow around the spinal cord can reverse even large syringomyelic cysts.

    Wise.
    Dr. Young,

    What, if any, is the drawback of shunting the syrinx, without removing the cause of occlusion, and thereby not restoring CSF flow? I have a syrinx that was causing loss of function. It was shunted and fortunately function was restored, but it seemed to me that's when my neuropathic pain and some other medical complications started. Always wondered if it's because the CSF is diverted elsewhere, rather than flowing downward. What's your opinion on this, if any?


    Thank you.

  8. #8
    Quote Originally Posted by quadvet View Post
    Dr. Young,

    What, if any, is the drawback of shunting the syrinx, without removing the cause of occlusion, and thereby not restoring CSF flow? I have a syrinx that was causing loss of function. It was shunted and fortunately function was restored, but it seemed to me that's when my neuropathic pain and some other medical complications started. Always wondered if it's because the CSF is diverted elsewhere, rather than flowing downward. What's your opinion on this, if any?


    Thank you.
    QV,

    The problem with shunting alone is recurrence of the syrinx. In the 1990's, when they were doing a lot of shunting, I recall the statistics suggesting that 80% of shunted syrinxes recurred within 2 years.

    You have asked an important question. I don't know what deleterious effects shunting the CSF may have on spinal cord function. Adhesions of the spinal cord to the surrounding arachnoid is associated with both loss of function, spasticity, and neuropathic pain.

    Wise.

  9. #9
    Quote Originally Posted by Wise Young View Post
    QV,

    The problem with shunting alone is recurrence of the syrinx. In the 1990's, when they were doing a lot of shunting, I recall the statistics suggesting that 80% of shunted syrinxes recurred within 2 years.

    You have asked an important question. I don't know what deleterious effects shunting the CSF may have on spinal cord function. Adhesions of the spinal cord to the surrounding arachnoid is associated with both loss of function, spasticity, and neuropathic pain.

    Wise.
    Wise,

    I should have mentioned that my syrinx was shunted in 1991. After the initial decrease in its size and return of function, MRIs over the years indicate no change, but that it is still there.

    So I'm not fully understanding what you mean by "recurrence". When shunted, the syrinx is supposed to go away completely?

    Thank you
    Last edited by quadvet; 07-06-2010 at 09:13 AM. Reason: clarification

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