Volume change theory for syringomyelia: A new perspective

Area of Science:

• Neurology
• Biophysics
• Fluid Dynamics

Background:

• The exact cause of syringomyelia (SM) remains unknown.
• This study proposes a novel theory linking SM genesis to fluid dynamics at the craniovertebral (CV) junction.
• Analysis focuses on volume changes in the spinal canal, cord, central canal, and subarachnoid space during postural movements.

Purpose of the Study:

• To present a new theory on syringomyelia pathogenesis based on craniovertebral junction fluid dynamics.
• To analyze the impact of postural changes (flexion/extension) on spinal and cerebrospinal fluid (CSF) volumes.
• To correlate these dynamics with the origin and propagation of syringomyelia.

Main Methods:

• Review of relevant scientific literature.
• Analysis of volume changes in spinal canal components during postural shifts.
• Postulation of cerebrospinal fluid (CSF) flow dynamics at the CV junction as a causative factor.

Main Results:

• Spinal canal volume is greater in flexion than extension.
• Postural changes induce differential shifts in spinal subarachnoid space (SAS) volume, influencing fluid movement.
• Cervical and lumbar regions experience maximum deformation due to their size and volume.

Conclusions:

• Altered spinal subarachnoid space (SSS) CSF volume during postural changes, if uncompensated by posterior fossa volume, can lead to syringomyelia.
• Blocked CSF exchange at the foramen magnum exacerbates syrinx formation during dynamic spinal loading.
• The theory supports surgical decompression and spinal immobilization as therapeutic strategies by addressing CSF dynamics.