Question:I have neck and shoulder pain on both sides from a condition called syringomyelia. I also have a mild Arnold-Chiari malformation. If I have surgery for this problem, will I get better neck motion? I can hardly bend my neck forward.
Answer:Syringomyelia is a general term used to describe a cavity that forms within the spinal cord. This tube-shaped cavity or cyst is sometimes referred to as a syrinx. The syrinx can expand, getting longer if it extends over several spinal levels. Over time, the syrinx can destroy the center of the spinal cord.
Arnold-Chiari refers to the physician who first described the condition. In the case of syringomyelia with Arnold-Chiari malformation, the lower part of the cerebellum protrudes from its normal location in the back of the head.
The word cerebellum means little brain. It is a separate, smaller part of the brain located at the base of the skull just above the cervical spine. It slides down into the cervical or neck portion of the spinal canal.
It sounds like you have developed syrinx in the cervical spine. Neck and shoulder pain with loss of cervical flexion are common with this condition. Surgery to remove the bone pressing on the spinal cord can help relieve the painful symptoms. The procedure is called foramen magnum decompression (FMD).
There isn't much information available about the effect of syringomyelia on cervical spine (neck) motion. Researchers in Japan explored the question of whether cervical motion is affected by the severity of the syringomyelia.
The study was small (30 patients). All had FMD for syringomyelia associated with Chiari malformation. Motion was measured before and after the operation. There was no significant difference pre- and postoperatively.
It does not appear that the loss of motion is linked with how severe the deformity is. More studies are needed to find out what restricts neck motion. With more information, treatment to improve motion may be possible.Atsushi Ono, MD, PhD, et al. Cervical Spinal Motion Before and After Surgery in Patients with Chiari Malformation Type I Associated with Syringomyelia. In Journal of Neurosurgery: Spine. November 2007. Vol. 7. No. 5. Pp. 473-477.
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