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Q: treatment for back problems ( Answered 3 out of 5 stars,   0 Comments )
Subject: treatment for back problems
Category: Health > Conditions and Diseases
Asked by: catz18-ga
List Price: $5.00
Posted: 13 Jul 2004 13:27 PDT
Expires: 12 Aug 2004 13:27 PDT
Question ID: 373629
what is the treatment for a tiny syrinx in the lower cervical region and what
activities to avoid
Subject: Re: treatment for back problems
Answered By: andrewxmp-ga on 13 Jul 2004 15:15 PDT
Rated:3 out of 5 stars
Hi catz18,

I found a few resources about syringomyelia (also known as a "syrinx")
that should be helpful.

A page discussing the condition in general can be found at:

University of Missouri-Columbia Health Sciences Center
[ ]
[ ]

National Institute of Neurological Disorders and Stroke
[ ]


"The treatment of choice depends on the cause of the syringomyelia.
For persons with syringomyelia due to Chiari Malformation,
decompression of the posterior fossa is the treatment of choice.  In
general, when the Chiari Malformation is decompressed, and the area
widened, CSF will resume the normal flow. This will, in turn allow the
syrinx to shrink. Many times, no further treatment is necessary.
A shunt (small, soft plastic tube) can be placed into the syrinx
cavity to drain CSF. The shunt is left in place and fluid is expected
to drain from the cavity, thereby shrinking the syrinx. This procedure
carries a moderately high risk of repeated replacements, therefore it
is less frequently used.
Medications can be used to treat the pain associated with
syringomyelia, and can be quite effective. Currently used medications
can include Neurontin, Amitriptyline, antiinflammatories, and
non-narcotic pain relievers."
[ ]

"Medical Care: 

No medical treatment is known for patients with syringomyelia.
However, a chronic, stable clinical course is common. Identifying the
underlying cause of syrinx formation is very important. Surgical
treatment most likely will be necessary.

Neurorehabilitative care facilitates preservation of remaining
neurological functions and prevents complications of quadriparesis
such as infection and decubitus ulcers.

Surgical Care: A variety of surgical treatments have been proposed for

Suboccipital and cervical decompression
This operation includes suboccipital craniectomy; laminectomy of C1,
C2, and sometimes C3; and duraplasty.
Some authors report microsurgical lysis of any adhesions, opening of
the fourth ventricular outlet, and plugging of the obex (later steps
are based on Gardner?s hydrodynamic theory).

Laminectomy and syringotomy (dorsolateral myelotomy)
After decompression, the syrinx is drained into the subarachnoid space
through a longitudinal incision in the dorsal root entry zone (between
the lateral and posterior columns), usually at the level of C2-C3.
Incision in the dorsal root entry area has the minimum risk of
increasing neurological deficit.

Ventriculoperitoneal shunt - Indicated if ventriculomegaly and
increased intracranial pressure are present

Lumboperitoneal shunt - Placed infrequently because of increased risk
of herniation through the foramen magnum

Syringosubarachnoid dorsal root entry zone shunt 

Syringoperitoneal shunt

Fourth ventriculostomy 

Percutaneous needling: This technique is advocated as a possible mode
of therapy; however, rapid refilling of the hydromyelic cavity from
the ventricular system follows aspiration of fluid at the time of
surgery. Moreover, a needle track seems unlikely to remain open.

Terminal ventriculostomy
The terminal ventricle is the dilated portion of the central canal
that extends below the tip of the conus medullaris into the filum
terminale. A laminectomy is performed over the caudal limit of the
fluid sac, and the filum is opened.
This procedure is suitable only in patients with symptoms of syrinx
without Chiari malformation. It is inappropriate in cases in which the
hydromyelic cavity does not extend into the lumbar portion of the
spinal cord or into the filum terminale.

Neuroendoscopic surgery
A fibroscope inserted through a small myelotomy allows inspection of
the intramedullary cavity.
This technique is particularly useful in evaluating and treating
multiple septate syrinxes.
Septa are fenestrated, either mechanically or by laser. Fluid from the
cavity is then shunted into the subarachnoid space."
[ ]

Activities to Avoid

"Patient Education: 

Avoid high-impact exercise, such as running and jumping in cases
associated with cervical instability.
Avoid activities involving Valsalva maneuvers."
[ ]

"Pain management techniques, adjustments in lifestyle and a carefully
planned physical or occupational therapy program may help to lessen
the symptoms of SM. Patients may be advised to avoid activities that
are associated with a high risk of injury. Physicians may recommend
limiting or abstaining from activities such as gymnastics, weight
lifting and contact sports."
[ ]

I trust this information has shed light on your questions, but if you
require a clarification, please request one, especially before rating
this answer.  Best wishes on your medical treatment, and thank you for
bringing this question to Google Answers!


Search terms used:
treatment syringomyelia cervical
treatment syringomyelia
treatment syringomyelia avoid activities
catz18-ga rated this answer:3 out of 5 stars
although the information provided was detailed and gave one much
needed  knowledge on the topic the information provided was difficult
to understand as it contained a great deal of unneccessary
uncomprehending words

There are no comments at this time.

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