Treatment for syringomyelia depends on the severity and progression of your signs and symptoms.
If syringomyelia is discovered on an MRI scan that's done for an unrelated reason, and syringomyelia isn't causing signs or symptoms, monitoring with periodic MRI and neurological exams may be all that's needed.
If syringomyelia is causing signs and symptoms that interfere with your daily life, or if signs and symptoms rapidly worsen, your doctor will usually recommend surgery.
The goal of surgery is to remove the pressure the syrinx places on your spinal cord and to restore the normal flow of cerebrospinal fluid. This can help improve your symptoms and nervous system (neurological) function. The type of surgery you'll need depends on the underlying cause of syringomyelia.
Several types of surgery options are available to reduce pressure on your brain and spinal cord. Surgery types include:
Treating Chiari malformation. If syringomyelia is caused by Chiari malformation, your doctor may recommend surgery that involves enlarging the opening at the base of your skull (suboccipital craniectomy) and expanding the covering of your brain (dura mater).
This surgery can reduce pressure on your brain and spinal cord, restore the normal flow of cerebrospinal fluid, and may improve or resolve syringomyelia.
- Draining the syrinx. To drain the syrinx, your doctor will surgically insert a drainage system, called a shunt. It consists of a flexible tube that keeps fluid from the syrinx flowing in the desired direction. One end of the tubing is placed in the syrinx, and the other is placed in another area of your body such as your abdomen.
- Removing the obstruction. If something within your spinal cord, such as a tumor or a bony growth, is hindering the normal flow of cerebrospinal fluid, surgically removing the obstruction may restore the normal flow and allow fluid to drain from the syrinx.
- Correcting the abnormality. If a spinal abnormality is hindering the normal flow of cerebrospinal fluid, surgery to correct it, such as releasing a tethered spinal cord, may restore normal fluid flow and allow the syrinx to drain.
Surgery doesn't always effectively restore the flow of cerebrospinal fluid, and the syrinx may remain, despite efforts to drain the fluid from it.
Follow-up care after surgery is critical because syringomyelia may recur. You'll need regular examinations with your doctor, including periodic MRIs, to assess the outcome of surgery.
The syrinx may grow over time, requiring additional treatment. Even after treatment, some signs and symptoms of syringomyelia may remain, as a syrinx can cause permanent spinal cord and nerve damage.