A Conservative Approach to Clinical Management of Syringomyelia

Syringomyelia is an abnormal collection of cerebrospinal fluid in the spinal cord. This fluid-filled cavity can elongate or expand over time, causing paresthesia, paralysis, or pain. We review the case of a 68-year-old woman with a thoracic syrinx from T5 to T11. The patient has a long-standing history of cervicalgia, lumbar radiculopathy, nerve root impingement, and degenerative disc disease. After years of chronic pain, the patient presented with worsening right-sided back pain that radiated to the umbilicus, which was initially treated with conservative pharmacotherapy. Due to inadequate pain management, etiologies outside of the previously diagnosed radiculopathy were considered. An incidental finding on an MRI of the thoracic spine demonstrated a thoracic syrinx extending from T5 to T11. A standardized approach to conservative clinical management for syringomyelia has not been established, which has led to difficulty in patient care for individuals suffering from chronic, symptomatic syrinx spinal cord disorders.