Causes and treatment of syringomyelia

Syringomyelia is mostly found in middle-aged people, rarely in children and the elderly, and more common in men than in women. Generally, the course of the disease is slow. The symptoms are relatively mild in the early stage of the disease. In the late stage, patients have sensory impairment, decreased or absent pain and temperature sensation, muscle weakness, decreased muscle tone, excessive or insufficient sweating, etc. MRI examination can clearly show the size and shape of the cavity in this plane.

Syringomyelia is a chronic, progressive disease of the spinal cord. The cause is not very clear, and the pathological characteristics are the formation of tubular cavities and proliferation of glial cells (non-neuronal cells) in the spinal cord (mainly gray matter). It often occurs in the cervical spinal cord. When the lesion involves the medulla oblongata, it is called syringobulbaria.

Causes of Syringomyelia

The exact cause is still unclear, but it can be divided into two categories: congenital developmental abnormalities and secondary syringomyelia, the latter of which is rare.

1. Congenital spinal neural tube atresia. This view is supported by the fact that this disease is often accompanied by other congenital abnormalities such as spina bifida, cervical ribs, scoliosis, and atrio-occipital deformity.

2. Abnormal spinal cord blood circulation. It causes spinal cord ischemia, necrosis, softening and cavity formation.

3. Mechanical factors. Due to congenital factors causing obstruction of the fourth ventricle outlet, the flow of cerebrospinal fluid from the fourth ventricle to the subarachnoid space is blocked. The pulsating waves of cerebrospinal fluid impact the central canal of the spinal cord downward, causing the central canal to expand and break through the wall of the central canal to form a cavity.

4. Others: such as cystic degeneration of spinal cord tumors, traumatic myelopathy, radiation myelopathy, spinal cord infarction, softening, intramedullary hemorrhage, necrotizing myelitis, etc.

Treatment of syringomyelia

1. General treatment

Neurotrophic drugs are used. Radiation therapy has been tried in the past, but the effectiveness is uncertain. Given that the disease is slowly progressive and is often associated with atrio-occipital malformation and cerebellar tonsillar herniation, which are believed to be related to the cause, surgical treatment should be adopted after a clear diagnosis.

2. Other treatments

Including B vitamins, vasodilators, nerve cell metabolic function activators, etc., can all be used. Physical therapy, physiotherapy, and acupuncture therapy can also be used according to the condition of the disease to promote the recovery of neurological function after surgery.