- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran.
Abolfazl Rahimizadeh, Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran.
DOI:10.25259/SNI_504_2022Copyright: © 2022 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
How to cite this article: Abolfazl Rahimizadeh, Mahan Amirzadeh, Alireza Azadeh. Syrinx associated with cervical spondylosis: A report of 13 cases. 22-Jul-2022;13:315
How to cite this URL: Abolfazl Rahimizadeh, Mahan Amirzadeh, Alireza Azadeh. Syrinx associated with cervical spondylosis: A report of 13 cases. 22-Jul-2022;13:315. Available from: https://surgicalneurologyint.com/surgicalint-articles/11735/
Background: Sustained compression of the spinal cord by cervical spondylosis may induce arachnoid fibrotic changes and trigger local syrinx formation.
Cases Description: Here, we describe 13 cases of syrinx formation in association with cervical spondylosis. In 12 out of 13 patients, the syrinx was incidental finding while screening for simple neck pain. In one case, it was discovered during an evaluation of upper extremity radiculopathy. Over the 3–8-year follow-up period, the syrinx size did not change in 11 cases (i.e., 10 asymptomatic and one with radiculopathy) even after surgical decompression. In the other two cases, the syrinx spontaneously resolved.
Conclusion: With the increased utilization of cervical MR imaging, more cases of incidental asymptomatic syrinx formation versus symptomatic lesions contributing to radiculopathy have been discovered.
Keywords: Cervical spondylosis, Radiculopathy, Spinal cord, Sustained compression, Syrinx
Syringomyelia is defines as a cystic cavitation within the spinal cord. It is generally associated with congenital malformations, trauma, postmeningitis, adhesive arachnoiditis, and tumors, but only rarely with cervical spondylosis.[
Thirteen patients, including nine males and four females, averaging 48.2 years of age, presented with cervical (i.e., C5-7 levels/average length of 18 mm and Axial 3.8 mm): 11 patients or upper thoracic syringomyelia attributed to cervical or thoracic spondylosis [
Syrinx formation in patients with cervical spondylosis is an extremely rare entity, with only 14 previously published cases. In addition, two cases with a combination of syringomyelia and thoracic ossification of the ligamentum flavum have been reported.[
Syrinxes in association with cervical/thoracic spondylosis should be differentiated from intramedullary cysts and/or intramedullary/intradural, extramedullary intradural, and/ or extradural arachnoid cysts.[
The size of syrinx varies in proportion to the severity of the attendant spondylosis. Therefore, advanced cervical spondylotic myelopathy results in larger syrinx formation versus smaller syrinxes with less severe spondylotic disease.[
Asymptomatic syrinxes due to cervical/thoracic spondylosis do not require surgery. Alternatively, patients with symptomatic syrinxes should undergo the most appropriate decompressive surgical procedure for their spondylotic disease rather than direct syrinx drainage.[
In symptomatic patients, surgical resection of cervical/ thoracic spondylosis typically results in resolution of attendant syrinx formation; the cysts do not require direct drainage/marsupialization/removal. However, the majority of patients with asymptomatic syrinxes attributed to spondylotic disease, neurologically either stabilize or experience spontaneous regression of their syrinxes without surgery.
The authors certify that they have obtained all appropriate patient consent.
There are no conflicts of interest.
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