SYRINGOMYELIA-MANAGEMENT

SUMMARY

1. Activity restrictions: avoid maneuvers that increase intrathoracic/abdominal pressure, such as weight lifting; anterior weight shifts; and Valsalva, Crede, and quad coughing, especially if these exacerbate symptoms.
2. Rehabilitation: functional training and adaptive equipment.
3. Pain management.
4. Close monitoring with symptomatic relief.

SURGERY
5. Surgery indicated for progressive neurological decline and/or severe intractable pain: shunting (syringo-subarachnoid, syringo-pleural, or syringo-peritoneal) followed by dissection of arachnoid adhesions & meningeal scarring, duraplasty.
6. Yields improved strength and pain control in most, but sensory recovery is not usually as favorable.
7. Recurrence of symptoms in approximately 50%.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.