Spontaneous regression of post-traumatic syringomyelia: A case report and literature review

Syringomyelia defines a condition in which myelopathy develops secondary to the formation of a cyst or cavity within the spinal cord parenchyma known as a syrinx. Although there is a significant volume of studies analysing the underlying mechanisms behind their formation, the management of such cavities remains an ongoing topic of debate. Aside from conservative approach, a range of surgical options exist, however long term outcomes are poor and a literature search reveals that the overall benefits are questionable. We present a 31-year-old man with an incidental finding of a syrinx on MRI following a traumatic spinal cord injury. Following a decompression and 360° fusion at the C6/7 level for a fracture-dislocation, the patient developed a delayed syrinx (54mm×11mm×8mm), and was managed conservatively. Over 2-year follow-up, the volume of the syrinx spontaneously reduced (46×5×5). Conservative treatment including careful observation is advisable as the first line therapy in patients with a post-traumatic syrinx. Surgery may be indicated in patients with progressive neurological symptoms, however there is a distinct lack of robust evidence on the long-term efficacy of surgery.