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Spinal Cord Injury Paralysis Resource Center

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Syringomyelia / Tethered Cord

Syringomyelia and tethered spinal cord can occur from months to many decades after spinal cord injury. In post-traumatic syringomyelia (sear-IN-go-my-EE-lia) a cyst or fluid-filled cavity forms within the cord. This cavity can expand over time, extending two or more spinal segments from the level of SCI. The clinical symptoms for syringomyelia and tethered spinal cord are the same and can include progressive deterioration of the spinal cord, progressive loss of sensation or strength, accompanied by sweating, spasticity, pain and autonomic dysreflexia (AD) -- new levels of disability long after a person has had a successful rehabilitation.

Tethered spinal cord is a condition where scar tissue forms and holds the spinal cord itself to the dura, the soft tissue membrane that surrounds it. This scarring prevents the normal flow of spinal fluid around the spinal cord and impedes the normal motion of the spinal cord within the membrane. Tethering causes cyst formation; it can occur without evidence of syringomyelia, but post-traumatic cystic formation does not occur without some degree of cord tethering.

Magnetic resonance imaging (MRI) detects cysts in the spinal cord, unless rods, plates or bullet fragments are present. Tethered cord and syringomyelia are treated surgically. Untethering involves a delicate surgery to release the scar tissue around the spinal cord to restore spinal fluid flow and the motion of the spinal cord. In addition, a small graft may be placed at the tethering site to fortify the dural space and decrease the risk of re-scarring. If a cyst is present, a shunt may be placed inside the cavity to drain fluid from the cyst. Surgery usually leads to improved strength and reduced pain; it does not always bring back lost sensory function.

Syringomyelia also occurs in people who have a congenital abnormality of the brain called a Chiari malformation. During development of the fetus, the lower part of the cerebellum protrudes from the base of the head into the cervical portion of the spinal canal. Symptoms usually include vomiting, muscle weakness in the head and face, difficulty swallowing, and varying degrees of mental impairment.

Paralysis of the arms and legs may also occur. Adults and adolescents with Chiari malformation who previously showed no symptoms may show signs of progressive impairment, such as involuntary, rapid, downward eye movements. Other symptoms may include dizziness, headache, double vision, deafness, an impaired ability to coordinate movement, and episodes of acute pain in and around the eyes.

Syringomyelia can also be associated with spina bifida, spinal cord tumors, arachnoiditis, and idiopathic (cause unknown) syringomyelia. MRI has significantly increased the number of diagnoses in the beginning stages of syringomyelia. Signs of the disorder tend to develop slowly, although sudden onset may occur with coughing or straining.

Surgery results in stabilization or modest improvement in symptoms for most people although delay in treatment may result in irreversible spinal cord injury. Recurrence of syringomyelia after surgery may make additional operations necessary; these operations may not be completely successful over the long term. Up to one half of those treated for syringomyelia have symptoms return within five years.

National Institute of Neurological Disorders and Stroke, American Syringomyelia & Chiari Alliance Project

A Reeve Foundation Fact Sheet on Syringomyelia (PDF)

American Syringomylia Association Project (ASAP)Nonprofit and nationwide clearinghouse for information on Chiari/syringomyelia.

Conquer ChiariConquer Chiari is our informal name, our goal, and our website. Chiari and syringomyelia are complicated diseases, which require complex solutions. No single action will beat them, but the combined efforts of many people on many fronts will. For far too long these diseases have destroyed people's lives, its time to fight back.

MedlinePlusStart here with 750 topics on conditions, diseases and wellness. MedlinePlus will direct you to information to help answer health questions. MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations. Preformulated MEDLINE searches are included in MedlinePlus and give easy access to medical journal articles. MedlinePlus also has extensive information about drugs, an illustrated medical encyclopedia, interactive patient tutorials, and latest health news.

National Institute of Neurological Disorders and StrokeProvides research overviews for all diseases and conditions related to paralysis.

SpineUniverseAt SpineUniverse our goal is to help patients and their families understand their back or neck problems. In clear, straightforward language we aim to explain what causes spinal problems and how they can be treated. We are committed to ensure that all of the information we present is trustworthy and of the highest quality.

Paralysis Resource Center The Reeve Foundation Paralysis Resource Center Information Specialists are reachable business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9:00 am to 5:00 pm ET. You may also schedule a call or send a message online.

Reeve Foundation Online Paralysis Community Connecting people living with paralysis, families, friends and caregivers so we can share support, experience, knowledge, and hope.

Quality of Life Grants DatabaseFind resources within the PRC Quality of Life Grants Database. Search by Zip Code, State or an Entire Category.

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The Reeve Foundation Paralysis Resource Center Information Specialists are reachable business weekdays, Monday through Friday, toll-free at 800-539-7309 from 9:00 am to 5:00 pm Eastern U.S. Time. International callers use 973-467-8270. You may also schedule a call or send a message online.

This project was supported, in part by grant number 90PR3002, from the U.S. Administration for Community Living, Department of Health and Human Services, Washington, D.C. 20201. Grantees undertaking projects under government sponsorship areencouraged to express freely their findings and conclusions. Points of view or opinions do not, therefore, necessarily represent official Administration for Community Living policy.