Identifying myelopathy caused by thoracic syringomyelia: a case report

Area of Science:

• Neurology
• Neurosurgery
• Spinal Cord Imaging

Background:

• Myelopathy, a neurological condition from spinal cord compression, is often assessed using upper and lower quarter screens.
• However, many components of these screens have limited or unstudied diagnostic accuracy.
• Identifying the cause of myelopathy, particularly in the thoracic spine, presents a diagnostic challenge.

Purpose of the Study:

• To detail the diagnostic journey for a patient with syringomyelia, an intramedullary lesion causing myelopathy.
• To illustrate the complexities in diagnosing thoracic spinal cord lesions.

Main Methods:

• Case report of a 47-year-old female diagnosed with a thoracic syrinx.
• Utilized spinal magnetic resonance imaging (MRI) for diagnosis.
• Described the clinical diagnostic course and subsequent surgical intervention and rehabilitation.

Main Results:

• A thoracic syrinx was identified via spinal MRI after a delayed clinical diagnosis.
• The patient underwent surgical treatment and a two-week inpatient rehabilitation.
• Post-intervention, the patient ambulated with a rolling walker and achieved modified independence in transfers.

Conclusions:

• A complex presentation of signs and symptoms, coupled with diagnostic methods relying on poorly validated screen components, created a diagnostic dilemma.
• This case underscores the necessity for further research into the diagnostic value of individual and combined neurological screening tests.
• Improved diagnostic strategies are needed for timely identification of patients requiring comprehensive imaging for spinal cord conditions.