Syrinx Disappearance Following Laminoplasty in Cervical Canal Stenosis Associated With Chiari Malformation -Case Report-

Abstract

A 50-year-old woman presented with nuchal pain, clumsiness in both hands, and gait disturbance. Cervical magnetic resonance (MR) imaging showed cervical canal stenosis at C3-C7 levels associated with a syrinx and cerebellar tonsillar herniation. The patient underwent C3-C7 laminoplasty. Her symptoms improved completely, and the patient was discharged 10 days after operation. Postoperative MR imaging showed disappearance of the syrinx. This case suggests that cerebellar tonsillar herniation may not cause syringomyelia. Posterior decompression, such as laminectomy and laminoplasty, without foramen magnum decompression may be an appropriate surgical strategy for diffuse cervical canal stenosis associated with syringomyelia below the narrow canal, even in the presence of co-existing Chiari malformation.

Cervical spinal canal narrowing in idiopathic syringomyelia

“…Clinical studies show that narrowing of spinal canal diameters increases peak CSF velocities [12]. Case reports document that syringomyelia may develop below cervical spinal stenosis [13]. Engineering models demonstrate that spinal stenosis alters CSF dynamics causing longitudinal pressure dissociation and transmural pressure gradients [14].…”

Syringomyelia Due to Thoracic Spinal Stenosis With Ossified Ligamentum Flavum -Case Report-

“…1,3,[5][6][7][8][9]12,14) Only one previous case of syringomyelia was associated with cervical ossification of the yellow ligament. 5) Ossification of the yellow ligament can induce myelopathy, most frequently in the lower thoracic spine.…”

“…4) In previous cases of syringomyelia due to cervical spondylosis, decompressive surgery without an intradural operation resulted in decreases in the size of the syrinx cavity and improvements in symptoms. 1,[5][6][7][8][9]12,14) Restoration of CSF flow dynamics between the syrinx and subarachnoid space by decompressive surgery was more effective than simply draining the syrinx cavity for the treatment of syringomyelia without Chiari malformations. 11) Decompression of the spinal subarachnoid space may have beneficial effects unless the patient shows longitudinally extensive arachnoiditis.…”

“…Several cases of syringomyelia caused by cervical spondylosis have been described previously. 1,3,[5][6][7][8][9]12,14) Long-standing blockade of cerebrospinal fluid (CSF) circulation is considered to be one of the main causes of syringomyelia associated with degenerative diseases of the cervical spine. 9) We present an unusual case of syringomyelia due to thoracic spinal stenosis associated with an ossified yellow ligament.…”

Cervicothoracic syringomyelia caused by cervical spinal stenosis: Case report and literature review

“…However, rarely has cervical spinal stenosis/spondylosis contributed to the formation of a cervicothoracic syrinx. [ 5 6 11 ] Here, we present a case of cervical canal stenosis resulting in C1–T3 syrinx formation, and provide a literature review.…”